Archives of Physical Medicine and Rehabilitation

journal homepage: www.archives-pmr.org

Archives of Physical Medicine and Rehabilitation 2019;-:-------

REVIEW ARTICLE

Abstracts of Low Back Pain Trials Are Poorly Reported,

Contain Spin of Information, and Are Inconsistent
With the Full Text: An Overview Study
Dafne P. Nascimento, PhD,a Leonardo O.P. Costa, PhD,a Gabrielle Z. Gonzalez, PhD,a
Christopher G. Maher, PhD,b Anne M. Moseley, PhDb
From the aMasters and Doctoral Programs in Physical Therapy, Universidade Cidade de Sao Paulo, Sao Paulo, Brazil; and bMusculoskeletal
Health Sydney, School of Public Health, The University of Sydney, Sydney, Australia.

Abstract
Objective: To investigate trials abstracts evaluating treatments for low back pain with regard to completeness of reporting, spin (ie, interpretation
of study results that overemphasizes the beneficial effects of the intervention), and inconsistencies in the data with the full text.
Data Sources: The search was performed on the Physiotherapy Evidence Database (PEDro) in February 2016.
Study Selection: This is an overview study of a random sample of 200 low back pain trials published between 2010 and 2015. The languages of
publication were restricted to English, Spanish, and Portuguese.
Data Extraction: Completeness of reporting was assessed using the Consolidated Standards of Reporting Trials (CONSORT) for abstracts
checklist (CONSORT-A). Spin was assessed using a spin checklist. Consistency between abstract and full text was assessed by applying the
assessment tools to both the abstract and full text of each trial and calculating inconsistencies in the summary score (paired t test) and agreement
in the classification of each item (kappa statistics). Methodologic quality was analyzed using the total PEDro score.
Data Synthesis: The mean number of fully reported items
SD for abstracts using the CONSORT-A was 5.1
2.4 out of 15 points. The mean
number of items
SD with spin was 4.9
2.6 out of 7 points. Abstract and full text scores were statistically inconsistent (PZ.01). There was
slight to moderate agreement between items of the CONSORT-A in the abstracts and full text (mean kappa
SD, 0.20
0.13) and fair to moderate
agreement for items of the spin checklist (mean kappa
SD, 0.47
0.09).
Conclusions: The abstracts were incomplete, with evidence of spin and inconsistent with the full text. We advise health care professionals to
avoid making clinical decisions based solely upon abstracts. Journal editors, reviewers, and authors are jointly responsible for improving abstracts,
which could be guided by amended editorial policies.
Archives of Physical Medicine and Rehabilitation 2019;-:-------
ª 2019 by the American Congress of Rehabilitation Medicine

Health care professionals use the results of randomized
controlled trials to assist their clinical decision making.1 How-
ever, they should be mindful that trials that are not adequately
conducted and reported may tend to overestimate treatment
Presented to the World Confederation for Physical Therapy, July 2e4, 2017, Cape Town,
South Africa; and to the International Back and Neck Pain Research Forum, September 12e15,
2017, Oslo, Norway.
Supported by the Sao Paulo Research Foundation (grant no. 2015/16953-2), which was con-
ducted as part of a PhD undertaken by D.P.N.
Disclosures: The authors declare that, even though 7 out of the 200 articles analyzed involved
authors from our research groups, all articles were evaluated with the same criteria and rigor.
effects.2 These exaggerated effects can be generated either due to
bias in the conduct of the trials or bias in the reporting of
the trials.3,4
Reading the full report of trial results is necessary to critically
appraise evidence.5,6 However, many health care professionals
decide to read the full text of an article only after reading the
abstract and some may only have easy access to the abstract.6,7
Therefore, the completeness of abstracts and consistency with
full text are important, also because trial abstracts are also widely
used in the screening process of systematic reviews.8 Common
problems with abstracts include incomplete and inadequate
reporting9,10 and inconsistencies between abstract and the full

0003-9993/19/$36 - see front matter ª 2019 by the American Congress of Rehabilitation Medicine
https://doi.org/10.1016/j.apmr.2019.03.024
2 D.P. Nascimento et al
text.11 Studies that have examined completeness of trial ab-
stracts12-17 using the Consolidated Standards of Reporting Trials
(CONSORT) for abstracts (CONSORT-A) checklist7 concluded
that completeness of reporting of abstracts was poor. There ap-
pears to be an association between completeness of reporting and
the number of centers,14 continent where the trial was conduct-
ed,18,19 abstract format,14 and year of publication of a trial.18,19
Shiwa et at20 concluded that English trials were more likely to
have better methodologic quality than trials written in other lan-
guages, therefore, completeness of reporting of abstracts might
also be related to the language. Studies have also found associa-
tions between better reporting quality and higher impact factor
journals,12,14,18,19 journals endorsement of the CONSORT rec-
ommendations,12,21 and abstracts with higher word counts.16
Studies that have compared abstracts and full texts in sports
injury prevention,17 general medicine,22 pharmacy,23 and psy-
chology24 found inconsistencies in 13% to 80% of articles.
Spin of information25-27 is another factor that can influence the
interpretation of abstracts. In research, spin is defined as “a
misrepresentation of study results, regardless of motive (inten-
tionally or unintentionally) that overemphasizes the beneficial
effects of the intervention and overstates safety compared with
that shown by the results.”28(p2) Spin may occur in a journal
publication, academic press releases, or media coverage of
research.27,29-32 A study conducted in the oncology field33 eval-
uated the impact of spin of results in trials abstracts using a 7-item
spin checklist and showed inconsistencies with the full text, such
as selective reporting and overstated treatment effects. To the best
of our knowledge, there is no study investigating the association
between abstract completeness of reporting and spin of informa-
tion, or even associating spin in abstracts with journal and trial
characteristics.
The issues of abstracts completeness, spin, and inconsistencies
with the full text have not been investigated in the low back pain
field. This is an important gap to address, as low back pain is
ranked the highest of all diseases for years lived with disability
and involves high costs worldwide.34,35 A recent publication in
one of the world’s leading general medical journals stated that
nonpharmacologic interventions, such as physiotherapy (including
exercise, education, graded activity, manual therapy), is the
preferred first-line treatment option for low back pain36 and is
congruent with guideline recommendations.37 Our primary ques-
tions were (1) are abstracts of low back pain randomized
controlled trials incomplete as assessed with the CONSORT-A?
(2) do these abstracts contain spin as assessed with the spin
checklist? and (3) are these abstracts inconsistent with the full text
in completeness and spin? Our secondary questions were (4) is
these abstracts’ completeness associated with certain trial or
journal characteristics? and (5) is abstracts’ spin associated with
“negative results” (ie, lack of statistical difference for primary
outcomes reported, or no difference for primary outcomes re-
ported at all)?
List of abbreviations:
CONSORT Consolidated Standards of Reporting Trials
CONSORT-A Consolidated Standards of Reporting Trials
for abstracts
PEDro Physiotherapy Evidence Database
Methods
Eligibility criteria
This is an overview study of 200 trials reporting the results of
randomized controlled trials, both abstracts and full text. First, we
searched for all randomized controlled trials coded as low back
pain, and published between 2010 and 2015, that were indexed on
the Physiotherapy Evidence Database (PEDro). We then selected a
random sample of 40% from all potentially eligible trials for the
study. The selection was performed using the random number
function in Excel.a PEDro was used because it is one of the most
complete indices of published reports of the results of randomized
controlled trials evaluating physiotherapy interventions, with no
restrictions on language or journal of publication.38 In addition, all
trial reports indexed on PEDro are rated for methodologic quality
using the PEDro scale,39 which enabled us to include methodo-
logic quality as an independent variable in the analyses of trial
characteristics associated with abstract completeness. The eligi-
bility criteria were a full-published trial reporting the results of a
randomized controlled trial evaluating at least 1 physiotherapy
intervention for low back pain; published in 2010 to 2015; in-
clusive; and written in English, Spanish, or Portuguese. The search
strategy performed on PEDro was “clinical trial” for method;
“lumbar spine, sacroiliac joint, or pelvis” for body part; “pain” for
problem; 2010 to 2015 for year of publication; and English,
Spanish, or Portuguese for language. This time period was
selected as it was after the release of the CONSORT-A in 20087;
therefore, we believe that authors would be prone to use these
recommendations. The language of publication was restricted to
English, Spanish, and Portuguese, as these were the languages
spoken by the authorship team of this study and are among the
most common languages of publication on PEDro.40
Data collection
Data extraction was divided into 5, to answer our research ques-
tions: (1) completeness of reporting of abstracts; (2) spin of in-
formation in abstracts; (3) abstract inconsistencies with the full
text; (4) association of abstract completeness and abstract spin
with trial and journal characteristics; and (5) association of ab-
stract spin with negative results. These sections are described in
detail below. Two independent authors extracted data. Disagree-
ments were resolved by discussion or arbitration by a third author.
Agreement of data extraction between raters before consensus was
calculated using kappa statistics.41 The agreement was calculated
for each item of the CONSORT-A and the spin checklist for both
abstract and full text.
Completeness of reporting of abstracts
The 17-item CONSORT-A7 was used to evaluate completeness of
reporting of the abstracts of the included trials. However, we
omitted 2 items in our data analyses because they were not rele-
vant to published articles of completed trials: “authors” (ie, related
to reporting of the contact details for the corresponding author in
conference proceedings) and “recruitment” (ie, indicates phase of
recruitment or ongoing). We then modified the CONSORT-A to 15
items. Each item was classified as “fully reported” (if reported all
information specified in the item) and “not reported” (if partially
reported the information specified in the item, if no information
www.archives-pmr.org
Abstracts of low back pain trials
specified in the item was reported, or when primary outcomes
were not specified) for each trial. We also generated a summary
score (CONSORT-A score) for each trial by counting the number
of items that were “fully reported.” The summary score could
range from 0 (low level of completeness of reporting) to 15
(high level of completeness of reporting).
We considered primary outcomes to be those identified as
“primary outcome” or “main outcome,” or any synonyms of the
word “outcome” (eg, endpoint). For trials that presented 1 or 2
outcomes only, we considered them as primary.
Spin of information in abstracts
We used a 7-item spin checklist33 to evaluate spin of information
in an abstract by comparing the abstract conclusion to the abstract
results. The list has been previously used to measure spin in
abstracts of randomized controlled trials in the field of oncology.33
Each item (items are listed in the results section) was classified as
“yes” (ie, the spin was clearly present, the primary outcome
results were not reported, or the primary outcome results were
omitted, all of which represented that the spin was also present) or
“no” (ie, the spin was not present). For example, if the authors of
the abstract gave a positive interpretation for a nonsignificant
result, we would classify item 6 (overenthusiastic interpretation of
outcomes) as “yes.” A summary score (spin-abstract score) was
calculated by counting the items classified as “yes” (items clas-
sified as “no” were considered free of spin of information). The
summary score could range from 0 (low levels of spin) to 7
(high levels of spin). At this point, the abstract was assessed in
isolation (not compared to the full text). We did this because
readers should be able to interpret the trial based on the results
section of the abstract.
The criterion for clinically important effects proposed by
Ostelo et al42 was used when scoring item 7 of the spin checklist.
These is a: 15-point difference for the visual analog scale
(0-100 points), 2-point difference for the numeric rating scale
(0-10 points), 5-point difference for the Roland Morris
Disability Questionnaire (0-24 points), 10-point difference for
the Oswestry Disability Index (0-100 points), and 20-point dif-
ference for the Quebec Back Pain Disability Scale (0-100 points).
Abstracts inconsistencies with the full text
Abstracts should reflect exactly what the full texts reported. Ab-
stracts have been compared to their corresponding full texts in
terms of completeness of reporting of all sections of a study and
spin of information in the results and conclusion sections.11,43
We used the CONSORT-A and the spin checklist to evaluate
inconsistencies in completeness of reporting and presence of spin
between the abstract and the corresponding full text, and the
reason why we also applied the CONSORT-A and the spin
checklist in the full texts. Summary scores were calculated for the
full text (CONSORTefull text score and spinefull text score) in
order to be comparable to the abstract (CONSORT-A score and
spin-abstract score). It was not our intention to analyze
completeness of reporting of full texts themselves. In addition to
that, for each individual item from the CONSORT-A and the spin
checklist, we calculated the agreement of how the item was
classified in the abstract with how it was classified in the full text.
Each full text was evaluated immediately after its abstract. If an
item of the full text was inconsistent with information reported in
the abstract, we would rescore such item in the abstract (eg, using
www.archives-pmr.org
3
the CONSORT-A: if we had classified the results for a primary
outcome as “fully reported” in the abstract and in the full text we
found out there were 2 primary outcomes which were also “fully
reported,” we would downgrade the item in the abstract to
“not reported”).
Description of trial and journal characteristics
To investigate if trial and journal characteristics were associated
with abstract completeness and with abstract spin, we defined 2
dependent variables and 10 independent variables. The dependent
variables were the CONSORT-A score and the spin-abstract score.
The independent variables were: trial conducted in more than 1
center; continent where trial was conducted; language of publi-
cation; 2015 journal impact factor; if journal endorses the CON-
SORT recommendations; number of words in abstract; structured
abstract; total PEDro score; spin-abstract score; and number of
years since trial publication. For the independent variables, we
classified each trial as unicenter or multicenter (ie, if the study had
been conducted in 1 or more centers). The country where the study
was conducted was extracted and categorized into continents
(using dummy variables for “Asia,” “Africa,” “Europe,” “North
America,” “Oceania,” and “South America”). The language was
classified as English or non-English. The journal impact factors
from 2015 were downloaded from the aggregated journal citations
list, Journal Citation Reports.b Journal endorsement of the CON-
SORT recommendations44 was extracted from the “Instructions to
Authors” section for each of the journals or from the CONSORT
recommendations’ website.45 The number of words in the abstract
was counted using the Microsoft Worda “word count” function.
The abstracts were classified as structured or not structured.46 The
total PEDro score (0-10 points, higher values indicate better
methodologic quality) was downloaded from PEDro. The number
of years since trial publication was calculated by subtracting the
year of publication from 2015.
Description of negative results
To investigate if trial negative results (ie, statistically nonsignifi-
cant or not reported between-group differences for the primary
outcomes) were associated with spin we defined 7 independent
variables (the individual items of the spin checklist) and 1
dependent variable (presence of statistically significant between-
group differences). The presence of statistical between-group
differences was determined for primary outcomes (2 at most and
preferably pain and disability) and considering up to 4 interven-
tion groups (the maximum number of groups from the included
trials), through confidence intervals (CIs) or P values. If the sta-
tistical between-group difference was in the opposite direction of
the hypothesis for at least 1 primary outcome, the trial was clas-
sified as “no” (or no statistical between-group difference). If the
between-group difference was not reported for at least 1 primary
outcome, the trial was classified as “not reported.” If all primary
outcomes had statistical between-group differences (in the direc-
tion of the hypothesis), the trial was classified as “yes.” The trials
classified as “no” and “not reported” were considered to have
negative results.
For descriptive analysis we also collected the maximum
number of words allowed in the abstract by the publishing journal.
This was extracted from the “Instructions to Authors” section.
Trial abstracts were classified into 4 categories: those that adhered
to word limit (ie, word count within 10 words of the word limit);
4 D.P. Nascimento et al

Identification
Records identified through database
searching
(n = 25.959)

Screening

Records screened
(n = 537)

Records excluded, with reasons (n = 67)

Ongoing study (n = 1)
Protocol (n = 1)
Duplicate (n = 1)
Not only low back pain (n = 64)
Full text trials assessed for
Eligibility

eligibility
(n = 470)

Trials included in
Included

quantitative synthesis
(n = 200)

Fig 1 Flow chart.

those that used less words than the word limit; those that exceeded
the word limit; and those published in a journal without abstract
word limits.
Data analysis
To investigate the completeness of reporting and spin of infor-
mation in the abstracts, the percentage of articles achieving each
item of the CONSORT-A and the spin checklist were tabulated.
The mean and SD summary score were calculated for each
checklist (CONSORT-A score and spin-abstract score). In order to
investigate inconsistencies between abstract and full text, we used
paired t tests between the CONSORT-A scores with the
CONSORTefull text scores and the spin-abstract scores with the
spinefull text scores, with P<.05. Agreement between the abstract
and full text for items 2-15 for the CONSORT-A (item 1 was
excluded as it relates to the title) and all items from the spin
checklist were calculated using kappa coefficients.41 Kappa values
higher than 0.61 (ie, “substantial” to “almost perfect agree-
ment”)41 were the criterion for “acceptable” agreement between
abstract and full text.
Linear regression models were built to evaluate the association
between 10 trial and journal characteristics with the CONSORT-A
score and the spin-abstract score. We built both univariate and
multivariate regression models. The independent variables with
P<.20 in the univariate model were included in the final multi-
variate model by using backward elimination method, until all
independent variables achieved P<.05. Adjusted explained vari-
ance (adjusted R2), beta coefficient (b) and its 95% CIs were re-
ported for each variable with possible association. Linearity was
assessed by evaluation of linear relationship of the CONSORT-A
score with each independent variable using simple scatter plots.47
Multicollinearity was tested with bivariate correlation analysis of
the CONSORT-A score with each independent variable, and
coefficients of independent variables with r0.7 were not
included in our linear regression model.48
Chi-square tests were used to evaluate the association between
trials with negative results and the presence of spin in the abstract
(ie, classified as “yes”) for each item of the spin checklist. All 7
items were evaluated to understand if individual items could have
different associations with negative results. SPSSc software
version 20.0 was used for all analyses.
Results
The search strategy retrieved 537 potentially eligible trial reports
from the 25,956 existing trials indexed in the PEDro database on

www.archives-pmr.org
Abstracts of low back pain trials 5

Table 1 Descriptive data for the included trials (NZ200)

Characteristics Mean
SD No. of Articles (%)
Journal Citation Reports impact factor 2015 2.5
2.5 157 (78.5)
Journals without impact factor 43 (21.5)
Open access articles 115 (57.5)
Written in English 198 (99.0)
Written in Portuguese or Spanish 2 (1.0)
Continents
Europe 70 (35.0)
Asia 65 (32.5)
North America 33 (16.5)
South America 13 (6.5)
Africa 8 (4.0)
Oceania 11 (5.5)
Multicenter 17 (8.5)
Unicenter 183 (91.5)
Structured abstract 171 (85.5)
Unstructured abstract 29 (14.5)
Age of trial (y) 3.4
1.7
2010 28 (14.0)
2011 35 (17.5)
2012 36 (18.0)
2013 34 (17.0)
2014 29 (14.5)
2015 38 (19.0)
Statistically significant between-group differences for the primary outcome(s) 70 (35.0)
No statistically significant between-group differences for the primary outcome(s) 96 (48.0)
Did not report between-group differences for the primary outcome(s) 34 (17.0)
Number of words in the abstract 258
67.3
Articles published in journals with abstract word limits 178 (89.0)
Abstracts that adhered to word limit 49 (24.5)
Abstracts that used less words than the word limit 64 (32.0)
Abstracts that exceeded the word limit 65 (32.5)
Abstracts that published in a journal without abstract word limits 22 (11.0)
Total PEDro score (/10) 5.8
1.6

February 1, 2016. Trials that were still in the recruitment stage,
protocols, duplicates, and those involving not only low back pain
were excluded (nZ67) and are detailed in supplemental
appendix S1 (available online only at http://www.archives-pmr.
org/). From the remaining 470 eligible trials, we randomly
selected a sample of approximately 40%, rounded up to 200 trials
(supplemental appendix S2, available online only at http://www.
archives-pmr.org/), as shown in the flow chart in figure 1. Jour-
nals and their impact factors are described in supplemental
appendix S3 (available online only at http://www.archives-pmr.
org/). Descriptive data for the 200 articles is presented in
table 1 and descriptive data of the 97 journals that published the
included trials are presented in supplemental appendix S3. Most
trials were conducted in Europe or Asia and published in English.
Most journals had an impact factor, more than half (51.5%)
endorsed CONSORT recommendations, and 38.1% were open
access. The methodologic quality of trials is presented in
supplemental appendix S4 (available online only at http://www.
archives-pmr.org/).
The agreement of data extraction between raters for both ab-
stract and full text ranged from fair to almost perfect
(see supplemental appendix S5, available online only at http://
www.archives-pmr.org/). For the items of the CONSORT-A the
mean kappa
SD was 0.73
0.18; and for the items of the spin
checklist the mean kappa was 0.67
0.11. We then resolved dis-
agreements by consensus.
Completeness of reporting of abstracts
The mean CONSORT-A score
SD was 5.1
2.4 out of 15
points. Table 2 presents the completeness of reporting for each
item of the CONSORT-A. The items with the highest
completeness of reporting were specifying the objective
(97.0%), interventions (76.5%), and trial design (61.5%). The
items with the lowest completeness of reporting were specifying
how participants were allocated to groups or randomization
(2.0%), blinding (2.5%), and a result for each group and the
estimated effect size and its precision for the primary out-
comes (4.5%).
Spin of information in abstracts
The mean
SD spin-abstract score was 4.9
2.6 out of 7
points, indicating that most abstracts overstated the results.
Table 3 presents the each item of the spin checklist. The most
common problems were failing to mention adverse events

www.archives-pmr.org
6 D.P. Nascimento et al

Table 2 Percentage of included trials achieving each item of the CONSORT-A in the abstract and full text (NZ200)
Fully Reported (%)
Item Description Abstract Full Text
1. Title Identification of the study as randomized 58.5
2. Trial design Description of the trial design 61.5 63.0
Methods
3. Participants Eligibility criteria for participants and the settings where the 44.5 89.5
data were collected
4. Interventions Interventions intended for each group 76.5 90.5
5. Objective Specific objective or hypothesis 97.0 95.5
6. Outcome Clearly defined primary outcome for this report 35.0 52.0
7. Randomization How participants were allocated to interventions 2.0 41.0
8. Blinding Whether or not participants, caregivers, and those assessing 2.5 15.5
the outcomes were blinded to group assignment
Results
9. Numbers randomized Number of participants randomized to each group 39.5 89.0
10. Numbers analyzed Number of participants analyzed in each group 10.5 88.0
11. Outcome For the primary outcome, a result for each group and the 4.5 32.5
estimated effect size and its precision
12. Harm Important adverse events or side effects 7.0 29.5
13. Conclusions General interpretation of the results 24.0 34.5
14. Trial registration Registration number and name of trial register 20.0 32.5
15. Funding Source of funding 23.5 68.5

(93.5% of abstracts), selective reporting of outcomes (73.0% of
abstracts), and recommendation of a treatment (73.0% of ab-
stracts). Ninety-eight percent of the abstracts had at least 1
item of spin.
Abstracts inconsistencies with the full text
Abstracts were reported less completely than the full text
(PZ.01). The mean CONSORT-A score
SD was 5.1
2.4
out of 15 compared to a mean CONSORTefull text score of
8.2
3.0, with a mean difference of -3.2 points (95% CI,
2.8-3.5). Agreement between the abstract and full text for
14 items from the CONSORT-A ranged from slight to
moderate agreement (mean kappa 0.20
0.14) (supplemental
appendix S6). The percentage of trials achieving each
individual item of the CONSORT-A for the abstract and full
text sections are presented in table 2. No abstracts fully
reported all 15 items (the highest number of items achieved
was 13), while full reporting of full text occurred for 3.0%
of trials.
Abstracts presented more spin of information than the full text
(PZ.01). The mean spin-abstract score was 4.9
2.6 out of 7 and
mean spinefull text score was 3.7
2.9, with a mean difference of
1.2 points (95% CI, 0.9-1.5). The ratings for the 7 items from the
spin checklist ranged from fair to moderate agreement (mean
kappa 0.49
0.11) between the abstract and full text
(see supplemental appendix S6, available online only at http://
www.archives-pmr.org/). Scoring for the individual items of the
spin checklist for both the abstract and full text are presented in
table 3. Only 2.0% abstracts and 17.0% full texts scored zero for

Table 3 Percentage of included trials containing each item of the spin checklist in the abstract and full text (NZ200)
Yes (%) No (%)
Description of Each Item Abstract Full Text Abstract Full Text
1. Omission of primary outcomes 56.0 40.5 44.0 59.5
2. Fail to mention adverse events of interventions 93.5 68.5 6.5 31.5
3. Selective reporting of positive results and omission of negative 73.0 53.5 27.0 46.5
results of primary outcomes
4. Fail to report statistically nonsignificant primary outcomes 71.0 51.0 29.0 49.0
5. Focus on statistically significant outcomes other than the primary 62.5 49.0 37.5 51.0
6. Overenthusiastic interpretation of statistically nonsignificant primary 61.5 47.5 38.5 52.5
outcomes results as effective
7. Recommendation of a treatment without a clinically important effect 73.0 60.5 27.0 39.5
on primary outcomes
NOTE. Abstracts and full texts free of spin are represented in column “no”; columns “yes” represent the percentage of abstracts and full texts presenting
spin of information.

www.archives-pmr.org
Abstracts of low back pain trials 7

Table 4 Final multivariate models of associations between trial and journal characteristics with the CONSORT-A score and the spin-abstract
score
Multivariate Regression Multivariate Regression
Dependent Variable: CONSORT-A Score Dependent Variable: Spin-Abstract Score
Adjusted R2Z0.55 Adjusted R2Z0.17
ConstantZ3.74 (95% CI, 1.94-5.54) ConstantZ11.20 (95% CI, 9.28-13.11)
Independent Variables b 95% CI P b 95% CI P
Number of centers .86 -1.58 -2.77 to -0.39 .01*
Continent .83 .74
Language .23y .25y
Journal impact factor 0.12 0.01-0.23 .04* .07
Journal endorses CONSORT recommendations 0.76 0.16-1.36 .01* .26y
Number of words in the abstract 0.01 0.00-0.01 .01* -0.01 -0.01 to -0.00 .01*
Structured abstract .46 .58y
Total PEDro score 0.23 0.04-0.42 .02* -.39 -0.60 to -0.18 .01*
SPIN-Abstract score -0.47 -0.58 to -0.36 .01* N/A N/A N/A
Age of the article .83y .29y
Abbreviation: N/A, not applicable.
* Values with P<.05.
y
Eliminated in the univariate analysis, values with P<.20.

the spin-abstract and spinefull text scores, which means they were
free of spin.
Association of abstract completeness and spin with
trial and journal characteristics
All variables were included into the linear regression model
exploring the association between abstract completeness and spin
with trial and journal characteristics. Simple scatter plots
confirmed the linearity assumption and bivariate correlation co-
efficients were all less than 0.31 (ie, multicollinearity assumption).
The final multivariate model explained 55% (adjusted R2Z0.55)
of the variance in completeness of reporting of abstracts and 17%
(adjusted R2Z0.17) of the variance in spin of information in ab-
stracts (table 4). Higher completeness of abstracts (CONSORT-A
score) was associated with higher journal impact factor, journals
that endorse CONSORT recommendations, greater number of
words in the abstract, higher total PEDro score, and lower spin-
abstract score. Lower score of spin in abstracts (spin-abstract
score) was associated with multicenter trials, greater number of
words in the abstract, and higher total PEDro score.
Association of abstract spin with negative results
Table 5 presents the association between spin of information in the
abstract and the presence of negative results for each item of spin
checklist. We observed an association (P<.05) between negative
results for 3 of the 7 items: selectively reported positive results
and ignored negative results of primary outcomes; fail to report
primary outcomes statistically nonsignificant; and recommenda-
tion to use a treatment, if it does not have an important minimal
clinical change. In other words, the presence of primary outcome
negative results was associated with the presence of spin in
the abstract.

Table 5 Association of trials presenting negative results with percentage of abstracts indicating the presence of spin for each of the spin
checklist (NZ200)
Description of Each Item Negative Results, (%) c2 Values P Values
1. Omission of primary outcomes 37.0 0.57 .75
2. Fail to mention adverse events of interventions 60.5 1.31 .52
3. Selective reporting of positive results and omission of negative results of 50.0 15.34 .01*
primary outcomes
4. Fail to report statistically nonsignificant primary outcomes 50.0 15.40 .01*
5. Focus on statistically significant outcomes other than the primary 41.0 2.20 .33
6. Overenthusiastic interpretation of statistically nonsignificant primary 41.0 3.88 .15
outcomes results as effective
7. Recommendation of a treatment without a clinically important effect on 47.0 11.20 .01*
primary outcomes
NOTE. Negative results are the sum of percentage of articles with statistically nonsignificant between-group differences and those that did not report a
statistically significant between-group difference.
* Values with P<.05.

www.archives-pmr.org
8 D.P. Nascimento et al
Discussion
Reporting of abstracts is incomplete in general medicine jour-
nals,49 oncology,14 and infectious diseases12 (mean CONSORT-A
scoresZ12.1 measured on a 17-point scale, 9.9 measured on a
18-point scale, and 7.7 measured on a 17-point scale, respec-
tively). Our analysis of trials evaluating physiotherapy in-
terventions for low back pain appears to have relatively lower
completeness of reporting in the abstract (mean CONSORT-A
scoreZ5.1). The description of items related to randomization,
blinding, results of primary outcomes, harms, and trial registration
were particularly problematic.
The presence of spin of information in abstracts is evident in
general medicine, as one study reported 41% of abstracts with at
least one type of spin27 whereas other authors found that 68.1%
had spin in at least 1 section of the abstract.25 The abstracts of trial
reports in low back pain appear to contain more spin of infor-
mation (98.0% of abstracts have at least 1 item of spin) than in
other areas of health care. Authors of analyzed trial reports tended
to either omit nonsignificant results for primary outcomes or
interpret them as beneficial, which can impact health care pro-
fessionals’ interpretation of abstract results.33
Consistency between abstracts and the full text is far from
perfect in the field of pharmacy (61% classified as inconsistent
with the full text),23 sports injury prevention (80% had at least 1
major inconsistency with the full text),17 psychology (average of
13% inconsistent abstracts compared to the full text),24 and
medicine (53% had data inconsistencies compared to the full
text).22 Using a differential approach, we have determined that
abstracts of trials evaluating physiotherapy interventions for low
back pain presented several inconsistencies with their full texts.
Important to note that these studies used different statistical
approaches, therefore, a direct comparison of our results with the
existing literature is not straightforward.
To simplify the evaluation of completeness of reporting and
spin, we generated summary scores for the CONSORT-A and the
spin checklist, which quantified these constructs as single,
dependent variables. Although this scale is not fully validated,50
the spin checklist presented moderate to almost perfect agree-
ment between raters. The use of summary scores will facilitate
future comparisons between different areas of health care and
evaluation of strategies to improve reporting and reduce spin.
Spin of information can negatively impact health care as
abstracts are commonly used by health care professionals to
inform treatment decisions33 and are widely disseminated in the
press and news.27 Spin can happen for many reasons, including
not understanding scientific standards, young researchers copying
previous bad practices, unconscious bias, intentional attempts to
influence the readers,51 and academic press releases to attract
readers’ attention.27,29-32 In addition, authors favoring or inter-
preting results as effective, when those are not statistically sig-
nificant, may induce journal reviewers and editors to accept an
article for publication.52 Whatever the cause of spin, this misin-
terpretation can potentially damage clinical practice and the
integrity of research.53,54
It seems that health care journals’ editors and reviewers are
either unaware of the importance of avoiding abstracts in-
consistencies with the full text55 or not sufficiently trained to
detect methodologic or reporting mistakes related to abstracts.56
Consequently, Moher and Altman57 described 4 actions to
improve the completeness, transparency, integrity, and value of
abstracts and papers published: (1) employment of a professional
publication officer; (2) developing core competencies for editors
and reviewers; (3) training for authors to write complete and
transparent papers; and (4) training for peer reviewers. These
training efforts could involve raising awareness of the academic
community to the available guidelines for reporting studies, ethics
in publication, integrity and responsibility in research, as well as
highlighting the issue of authors overstating their results.25
Authors could also be encouraged to write the abstract after the
full text has been finalized. Programs with this type of content that
target authors, journal editors, and reviewers could and should be
implemented.
Our analysis of article characteristics associated with better
abstract reporting and avoiding spin in abstracts identified vari-
ables that predict better reporting and interpretation. Higher
completeness of reporting was associated with publication in
journals with higher impact factors and that endorse CONSORT
recommendations, greater number of words in the abstract, higher
total PEDro score, and a lower spin-abstract score. Additionally,
avoiding spin was also related to conducting the trial in more than
one center, which may be explained to the fact that different in-
stitutions are involved in the writing process and consequently the
manuscript is peer reviewed by a broader group of researchers.
Two possible strategies involve changing a journal’s editorial
policies to increase the number of words permitted in the abstract
to at least 350 words (500 words ideally) and endorsing (and
using) the CONSORT recommendations, including the extension
for abstracts. Recommendations on using journal impact factor as
reference for publication have been discussed since 2005 and have
been considered to be partially inappropriate.58
Study strengths and limitations
One of the strengths of this study is the representative sample of
42% of all trials evaluating physiotherapy interventions for low
back pain published in 2010 to 2015. Additionally, we used the
CONSORT-A7 to evaluate completeness of reporting. This
checklist has been used previously to compare conference
abstracts with the abstract subsequently used in the full publica-
tion of the trial17 and seems to be a good measurement tool to
compare the level of agreement between abstract and full text in
our study. Furthermore, the assessment of spin has been consid-
ered to be somewhat subjective and difficult to evaluate.50 To
address this concern, we used a recent developed spin checklist.33
In the attempt to limit subjectivity, we used 2 reviewers to inde-
pendently score the included trials, with disagreements resolved
by consensus. A limitation of this study was that abstracts not
clearly defining the primary outcomes were automatically classi-
fied as containing spin of information, as most of the items of the
spin checklist relate to the primary outcomes. In order not to
overestimate spin, if a trial only reported 1 or 2 outcomes but did
not explicitly state that the outcomes were “primary,” we
considered them to be the primary outcomes when applying the
spin checklist. Another limitation relates to the evaluation of
agreement between raters, which did not take into account the
interdependency of the items in the spin checklist.
Conclusions
Similar to other health care trials, the abstracts of randomized
controlled trials evaluating physiotherapy interventions for low
back pain are incompletely reported, contain spin of information,
www.archives-pmr.org
Abstracts of low back pain trials
and are inconsistent with the full text. Authors, reviewers, and
journal editors need to improve the completeness of reporting and
reduce spin of results in abstracts. In order to do so, we encourage
journal editors to consider changing some editorial policies, such
as increasing the number of words allowed in the abstract and
offering adequate training to improve peer reviewers attention to
abstracts (in terms of reporting, interpretation of results, and
consistency of data between abstract and full text). Journal editors
and reviewers should jointly be responsible for improving research
integrity, transparency, and ethics in the publication process.
Finally, authors of trials should carefully choose journals with
strict methodologic and reporting standards for publication, as
well as writing the abstract only when the full text has
been finalized.
Suppliers
a. Microsoft Excel; Microsoft Corporation.
b. Journal Citation Reports; Clarivate Analytics.
c. SPSS software v. 20; IBM Corp.
Keywords
Abstracting and indexing as topic; Data accuracy; Low back pain;
Randomized controlled trials as topic; Rehabilitation
Corresponding author
Dafne P. Nascimento, PhD, Masters and Doctoral Programs in
Physical Therapy, Universidade Cidade de Sao Paulo, Rua Cesario
Galeno 448, Tatuape, Sao Paulo, SP e Brazil, CEP 03071-000. E-
mail address: dafnepn@yahoo.com.br.
Acknowledgment
We thank all authors and funders of the randomized controlled
trial studies that contributed data to the present study.
References
1. Herbert R, Jamtvedt G, Mead J, Hagen KB. Practical evidence-based
physiotherapy. 2nd ed. Oxford, England: Elsevier Butterworth-Hei-
nemann; 2011.
2. Wood L, Egger M, Gluud LL, et al. Empirical evidence of bias in
treatment effect estimates in controlled trials with different in-
terventions and outcomes: meta-epidemiological study. BMJ 2008;
336:601-5.
3. Costa LO, Maher CG, Lopes AD, de Noronha MA, Costa LC.
Transparent reporting of studies relevant to physical therapy practice.
Rev Bras Fisioter 2011;15:267-71.
4. Savovic J, Jones HE, Altman DG, et al. Influence of reported study
design characteristics on intervention effect estimates from random-
ized, controlled trials. Ann Intern Med 2012;157:429-38.
5. The PLoS Medicine Editors. The impact of open access upon public
health. PLoS Med 2006;3:e252.
6. Gotzsche PC. Believability of relative risks and odds ratios in ab-
stracts: cross sectional study. BMJ 2006;333:231-4.
www.archives-pmr.org
9
7. Hopewell S, Clarke M, Moher D, et al. CONSORT for reporting
randomized controlled trials in journal and conference abstracts:
explanation and elaboration. PLoS Med 2008;5:201-9.
8. Dijkers MP. Searching the literature for information on traumatic
spinal cord injury: the usefulness of abstracts. Spinal Cord 2003;41:
76-84.
9. Chhapola V, Tiwari S, Brar R, Kanwal SK. Reporting quality of trial
abstracts-improved yet suboptimal: a systematic review and meta-
analysis. J Evid Based Med 2018;11:89-94.
10. Song SY, Kim B, Kim I, et al. Assessing reporting quality of ran-
domized controlled trial abstracts in psychiatry: adherence to CON-
SORT for abstracts: a systematic review. PLoS One 2017;12:
e0187807.
11. Li G, Abbade LPF, Nwosu I, et al. A scoping review of comparisons
between abstracts and full reports in primary biomedical research.
BMC Med Res Methodol 2017;17:181.
12. Bigna JJ, Noubiap JJ, Asangbeh SL, et al. Abstracts reporting of
HIV/AIDS randomized controlled trials in general medicine and in-
fectious diseases journals: completeness to date and improvement in
the quality since CONSORT extension for abstracts. BMC Med Res
Methodol 2016;16:138.
13. Ghimire S, Kyung E, Kang W, Kim E. Assessment of adherence to the
CONSORT statement for quality of reports on randomized controlled
trial abstracts from four high-impact general medical journals. Trials
2012;13:77.
14. Ghimire S, Kyung E, Lee H, Kim E. Oncology trial abstracts showed
suboptimal improvement in reporting: a comparative before-and-after
evaluation using CONSORT for abstract guidelines. J Clin Epidemiol
2014;67:658-66.
15. Guo JW, Iribarren SJ. Reporting quality for abstracts of randomized
controlled trials in cancer nursing research. Cancer Nurs 2014;37:
436-44.
16. Wang L, Li Y, Li J, et al. Quality of reporting of trial abstracts needs to
be improved: using the CONSORT for abstracts to assess the four
leading Chinese medical journals of traditional Chinese medicine.
Trials 2010;11:75.
17. Yoon U, Knobloch K. Assessment of reporting quality of conference
abstracts in sports injury prevention according to CONSORT and
STROBE criteria and their subsequent publication rate as full papers.
BMC Med Res Methodol 2012;12:47.
18. Lai R, Chu R, Fraumeni M, Thabane L. Quality of randomized
controlled trials reporting in the primary treatment of brain tumors. J
Clin Oncol 2006;24:1136-44.
19. Peron J, Pond GR, Gan HK, et al. Quality of reporting of modern
randomized controlled trials in medical oncology: a systematic review.
J Natl Cancer Inst 2012;104:982-9.
20. Shiwa SR, Moseley AM, Maher CG, Pena Costa LO. Language of
publication has a small influence on the quality of reports of controlled
trials of physiotherapy interventions. J Clin Epidemiol 2013;66:78-84.
21. Turner L, Shamseer L, Altman DG, et al. Consolidated standards of
reporting trials (CONSORT) and the completeness of reporting of
randomised controlled trials (RCTs) published in medical journals.
Cochrane Database Syst Rev 2012;11:MR000030.
22. Fontelo P, Gavino A, Sarmiento RF. Comparing data accuracy be-
tween structured abstracts and full-text journal articles: implications in
their use for informing clinical decisions. Evid Based Med 2013;18:
207-11.
23. Ward LG, Kendrach MG, Price SO. Accuracy of abstracts for original
research articles in pharmacy journals. Ann Pharmacother 2004;38:
1173-7.
24. Harris AH, Standard S, Brunning JL, et al. The accuracy of abstracts
in psychology journals. J Psychol 2002;136:141-8.
25. Boutron I, Dutton S, Ravaud P, Altman DG. Reporting and interpre-
tation of randomized controlled trials with statistically nonsignificant
results for primary outcomes. JAMA 2010;303:2058-64.
26. Chiu K, Grundy Q, Bero L. Spin’ in published biomedical literature: a
methodological systematic review. PLoS Biol 2017;15:e2002173.
10
27. Yavchitz A, Boutron I, Bafeta A, et al. Misrepresentation of ran-
domized controlled trials in press releases and news coverage: a cohort
study. PLoS Med 2012;9:e1001308.
28. Haneef R, Yavchitz A, Ravaud P, et al. Interpretation of health news
items reported with or without spin: protocol for a prospective meta-
analysis of 16 randomised controlled trials. BMJ Open 2017;7:
e017425.
29. Incomplete reporting of research in academic press releases. Lancet
2009;373:1920.
30. Haneef R, Lazarus C, Ravaud P, Yavchitz A, Boutron I. Interpretation
of results of studies evaluating an intervention highlighted in Google
Health News: a cross-sectional study of news. PLoS One 2015;10:
e0140889.
31. Schwartz LM, Woloshin S, Andrews A, Stukel TA. Influence of
medical journal press releases on the quality of associated newspaper
coverage: retrospective cohort study. BMJ 2012;344:d8164.
32. Woloshin S, Schwartz LM, Casella SL, Kennedy AT, Larson RJ. Press
releases by academic medical centers: not so academic? Ann Intern
Med 2009;150:613-8.
33. Boutron I, Altman DG, Hopewell S, Vera-Badillo F, Tannock I,
Ravaud P. Impact of spin in the abstracts of articles reporting results of
randomized controlled trials in the field of cancer: the SPIIN ran-
domized controlled trial. J Clin Oncol 2014;32:4120-6.
34. Global Burden of Disease. Disability-adjusted life-years Hale Col-
laborators. Global, regional, and national disability-adjusted life-years
(DALYs) for 315 diseases and injuries and healthy life expectancy
(HALE), 1990-2015: a systematic analysis for the Global Burden of
Disease Study 2015. Lancet 2016;388:1603-58.
35. Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is
and why we need to pay attention. Series. Low back pain 1. Lancet
2018;391:2356-67.
36. Foster NE, Anema JR, Cherkin D, et al. Prevention and treatment of
low back pain: evidence, challenges, and promising directions. Series.
Low back pain 2. Lancet 2018;391:2368-83.
37. Bernstein IA, Malik Q, Carville S, Ward S. Low back pain and
sciatica: summary of NICE guidance. BMJ 2017;356:i6748.
38. Michaleff ZA, Costa LO, Moseley AM, et al. CENTRAL, PEDro,
PubMed, and EMBASE are the most comprehensive databases
indexing randomized controlled trials of physical therapy in-
terventions. Phys Ther 2011;91:190-7.
39. Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M.
Reliability of the PEDro scale for rating quality of randomized
controlled trials. Phys Ther 2003;83:713-21.
40. PEDro. PEDro statistics. Available at: https://www.pedro.org.au/
english/downloads/pedro-statistics. Accessed July 8, 2018.
41. Viera AJ, Garrett JM. Understanding interobserver agreement: the
kappa statistic. Fam Med 2005;37:360-3.
42. Ostelo RW, Deyo RA, Stratford P, et al. Interpreting change scores for
pain and functional status in low back pain: towards international
D.P. Nascimento et al
consensus regarding minimal important change. Spine (Phila Pa 1976)
2008;33:90-4.
43. Assem Y, Adie S, Tang J, Harris IA. The over-representation of sig-
nificant p values in abstracts compared to corresponding full texts: a
systematic review of surgical randomized trials. Contemp Clin Trials
Commun 2017;7:194-9.
44. Moher D, Hopewell S, Schulz KF, et al. CONSORT 2010 explanation
and elaboration: updated guidelines for reporting parallel group
randomised trials. J Clin Epidemiol 2010;63:e1-37.
45. CONSORT Transparent Reporting of Trials. Endorsers journals and
organizations. Available at: http://www.consort-statement.org/about-
consort/endorsers. Accessed July 8, 2018.
46. Nakayama T, Hirai N, Yamazaki S, Naito M. Adoption of structured
abstracts by general medical journals and format for a structured ab-
stract. J Med Libr Assoc 2005;93:237-42.
47. Zhou Z, Ku HC, Xing G, Xing C. Decomposing Pearson’s chi(2) test:
a linear regression and its departure from linearity. Ann Hum Genet
2018;82:318-24.
48. Prunier JG, Colyn M, Legendre X, Nimon KF, Flamand MC. Multi-
collinearity in spatial genetics: separating the wheat from the chaff
using commonality analyses. Mol Ecol 2015;24:263-83.
49. Mbuagbaw L, Thabane M, Vanniyasingam T, et al. Improvement in
the quality of abstracts in major clinical journals since CONSORT
extension for abstracts: a systematic review. Contemp Clin Trials
2014;38:245-50.
50. Horton R. The hidden research paper. JAMA 2002;287:2775-8.
51. Fletcher RH, Black B. “Spin” in scientific writing: scientific mischief
and legal jeopardy. Med Law 2007;26:511-25.
52. Kien C, Nussbaumer B, Thaler KJ, et al. Barriers to and facilitators of
interventions to counter publication bias: thematic analysis of schol-
arly articles and stakeholder interviews. BMC Health Serv Res 2014;
14:551.
53. Simera I, Altman DG. ACP Journal Club. Editorial: writing a research
article that is “fit for purpose”: EQUATOR Network and reporting
guidelines. Ann Intern Med 2009;151. JC2-2, JC2-3.
54. Page MJ, McKenzie JE, Forbes A. Many scenarios exist for selective
inclusion and reporting of results in randomized trials and systematic
reviews. J Clin Epidemiol 2013;66:524-37.
55. Lazarus C, Haneef R, Ravaud P, Hopewell S, Altman DG, Boutron I.
Peer reviewers identified spin in manuscripts of nonrandomized
studies assessing therapeutic interventions, but their impact on spin in
abstract conclusions was limited. J Clin Epidemiol 2016;77:44-51.
56. Hopewell S, Collins GS, Boutron I, et al. Impact of peer review on
reports of randomised trials published in open peer review journals:
retrospective before and after study. BMJ 2014;349:g4145.
57. Moher D, Altman DG. Four proposals to help improve the medical
research literature. PLoS Med 2015;12:e1001864.
58. Announcement: Nature journals support the San Francisco Declaration
on Research Assessment. Nature 2017;544:394.
www.archives-pmr.org
www.archives-pmr.org

Abstracts of low back pain trials

Supplemental Appendix S1
Excluded Trials

Year Journal Title Reason for exclusion

2010 Physiotherapy Theory and Practice The use of sensory electrical stimulation for pressure ulcer prevention Not low back pain, pressure ulcer.
2010 Academic Emergency Medicine Heat or cold packs for neck and back strain: a randomized controlled trial of efficacy Not only low back pain, neck and thoracic
spine.
2010 BMC Musculoskeletal Disorders The long-term effects of naprapathic manual therapy on back and neck pain - results from a Not only low back pain, neck and thoracic
pragmatic randomized controlled trial spine.
2010 BMC Musculoskeletal Disorders The long-term effects of naprapathic manual therapy on back and neck pain - results from a Not only low back pain, neck and thoracic
pragmatic randomized controlled trial spine.
2010 Pain Medicine Predictors of pain outcomes in patients with chronic musculoskeletal pain co-morbid with Not low back pain, musculoskeletal pain
depression: results from a randomized controlled trial in general.
2010 Physical Therapy Effects of traditional sit-up training versus core stabilization exercises on short-term Not low back pain, musculoskeletal
musculoskeletal injuries in US army soldiers: a cluster randomized trial injuries in general.
2011 Physiotherapy Effect of a high-density foam seating wedge on back pain intensity when used by 14 to Not only low back pain, neck and thoracic
16-year-old school students: a randomised controlled trial spine.
2011 BMC Public Health Effects on musculoskeletal pain, work ability and sickness absence in a 1-year randomised Not low back pain, musculoskeletal pain
controlled trial among cleaners in general.
2011 Pain Practice Comparison of acupuncture to injection for myofascial trigger point pain Not low back pain, myofascial trigger
point pain.
2011 The Journal of Rheumatology Rehabilitation treatment in patients with ankylosing spondylitis stabilized with tumor Not low back pain, ankylosing spondylitis.
necrosis factor inhibitor therapy. A randomized controlled trial
2011 Revista Brasileira de Fisioterapia Effects of two physical therapy interventions in patients with chronic non-specific low back Partial analysis, study still ongoing.
[Brazilian Journal of Physical Therapy] pain: feasibility of a randomized controlled trial
2011 Pain Impact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and Not low back pain, physiotherapists
recommendations of health care providers about low back pain: a randomised clinical beliefs.
trial
2011 Italian Journal of Physiotherapy Effect of a physiotherapy program in the management of musculoskeletal disorders in Not low back pain, musculoskeletal
hairdressers: a randomized controlled trial injuries in general.
2011 Journal of Bodywork and Movement Fascial release effects on patients with non-specific cervical or lumbar pain Not only low back pain, neck and thoracic
Therapies spine.
2011 Turkish Journal of Rheumatology Long-term effects of comprehensive inpatient rehabilitation on function and disease Not low back pain, chronic rheumatoid
activity in patients with chronic rheumatoid arthritis and ankylosing spondylitis arthritis and ankylosing spondylitis.
2011 Scandinavian Journal of Work, Kettlebell training for musculoskeletal and cardiovascular health: a randomized controlled Not low back pain, musculoskeletal pain
Environment & Health trial in general.
2011 Journal of Rehabilitation Medicine Efficacy of rehabilitation for patients with ankylosing spondylitis: comparison of a four- Not low back pain, ankylosing spondylitis.
week rehabilitation programme in a Mediterranean and a Norwegian setting
(continued on next page)

10.e1
 10.e2
(continued )
Year Journal Title Reason for exclusion
2011 Scandinavian Journal of Work, The effectiveness of participatory ergonomics to prevent low-back and neck pain - results Not only low back pain, neck and thoracic
Environment & Health of a cluster randomized controlled trial spine.
2011 European Spine Journal Long-term effectiveness of a back education programme in elementary school children: an Not only low back pain, neck and thoracic
8-year follow-up study spine.
2011 Journal of Bodywork and Movement The immediate effects of traditional Thai massage on heart rate variability and stress- Not only low back pain, neck and thoracic
Therapies related parameters in patients with back pain associated with myofascial trigger points spine.
2011 Indian Journal of Physiotherapy and Effectiveness of coccygeal manipulation in coccydynia: a randomized control trial Duplicate.
Occupational Therapy
2012 Disability and Rehabilitation Effectiveness of different interventions using a psychosocial subgroup assignment in Not only low back pain, neck and thoracic
chronic neck and back pain patients: a 10-year follow-up spine.
2012 Journal of Athletic Training Lumbopelvic joint manipulation and quadriceps activation of people with patellofemoral Not low back pain, patellofemoral pain
pain syndrome syndrome.
2012 Rheumatology International Effect of Pilates training on people with ankylosing spondylitis Not low back pain, ankylosing spondylitis.
2012 Medical Science Monitor The objective evaluation of effectiveness of manual treatment of spinal function Not only low back pain, neck and thoracic
disturbances spine.
2012 Iranian Red Crescent Medical Journal A randomized clinical trial of fibromyalgia treatment with acupuncture compared with Not low back pain, fibromyalgia.
fluoxetine
2012 Clinical Cases in Mineral and Bone A randomized control trial on the effectiveness of osteopathic manipulative treatment in Not low back pain, osteoporosis.
Metabolism reducing pain and improving the quality of life in elderly patients affected by
osteoporosis
2012 The American Journal of Chinese Medicine Randomized controlled pilot study: pain intensity and pressure pain thresholds in patients Not only low back pain, neck and thoracic
with neck and low back pain before and after traditional East Asian “Gua Sha” therapy spine.
2012 Pain A randomized controlled evaluation of an online chronic pain self management program Not low back pain, chronic pain in
general.
2012 Pain Is there a potential role for attention bias modification in pain patients? Results of 2 Not low back pain, acute and chronic pain
randomised, controlled trials in general.
2012 Journal of Bodywork and Movement The effectiveness of the Pilates method: reducing the degree of non-structural scoliosis, Not only low back pain, neck and thoracic
Therapies and improving flexibility and pain in female college students spine.
2012 Journal of Physical Therapy Science Stretching versus mechanical traction of the spine in treatment of idiopathic scoliosis Not low back pain, scoliosis in the spine.
2013 BMC Musculoskeletal Disorders Implementation of specific strength training among industrial laboratory technicians: Not only low back pain, neck and upper
long-term effects on back, neck and upper extremity pain limbs.
2013 Journal of Rehabilitation Medicine A three-week multidisciplinary in-patient rehabilitation programme had positive long-term Not low back pain, ankylosing spondylitis.
effects in patients with ankylosing spondylitis: randomized controlled trial
2013 Journal of Strength & Conditioning Effect of specific resistance training on musculoskeletal pain symptoms: dose-response Not low back pain, musculoskeletal pain
Research relationship in general.
www.archives-pmr.org

D.P. Nascimento et al
2013 Turkish Journal of Rheumatology A comparison of the efficacy of dry needling, lidocaine injection, and oral flurbiprofen Not low back pain, myofascial pain
treatments in patients with myofascial pain syndrome: a double-blind (for injection syndrome.
groups only), randomized clinical trial
2013 Spine Short term usual chiropractic care for spinal pain: a randomised controlled trial Not only low back pain, neck and thoracic
spine.
(continued on next page)
www.archives-pmr.org

Abstracts of low back pain trials

(continued )
Year Journal Title Reason for exclusion
2013 Applied Ergonomics Office ergonomics training and a sit-stand workstation: effects on musculoskeletal and Not low back pain, musculoskeletal pain
visual symptoms and performance of office workers in general.
2013 Clinical Rehabilitation Supervised training and home-based rehabilitation in patients with stabilized ankylosing Not low back pain, ankylosing spondylitis.
spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month
follow-up
2013 Annals of Agricultural & Environmental Physical therapy versus medical treatment of musculoskeletal disorders in dentistry - a Not low back pain, musculoskeletal pain
Medicine randomised prospective study in general.
2013 Arthritis Care & Research Effect of cardiovascular training on fitness and perceived disease activity in people with Not low back pain, ankylosing spondylitis.
ankylosing spondylitis
2013 Spine Outcomes of Usual Chiropractic Harm (OUCH) randomised controlled trial of adverse events Protocol.
2013 Clinical and Experimental Rheumatology Outcome of an education and home-based exercise programme for patients with ankylosing Not low back pain, ankylosing spondylitis.
spondylitis: a nationwide randomized study
2013 Swiss Medical Weekly Culturally sensitive group therapy for Turkish patients suffering from chronic pain: a Not low back pain, chronic pain in
randomised controlled intervention trial general.
2013 Rheumatology International The effects of combined spa therapy and rehabilitation on patients with ankylosing Not low back pain, ankylosing spondylitis.
spondylitis being treated with TNF inhibitors
2013 The Journal of Orthopaedic and Sports Efficacy of thrust and non-thrust manipulation and exercise with or without the addition of Not low back pain, ankle sprain.
Physical Therapy myofascial therapy for the management of acute post-inversion ankle sprain: a
randomized clinical trial
2013 Spine A randomized trial of balloon kyphoplasty and non-surgical management for treating acute Not low back pain, kyphosis correction.
vertebral compression fractures: vertebral body kyphosis correction and surgical
parameters
2014 Rheumatology International Effects of Pilates, McKenzie and Heckscher training on disease activity, spinal motility and Not low back pain, ankylosing spondylitis.
pulmonary function in patients with ankylosing spondylitis: a randomized controlled
trial
2014 Journal of Physical Activity & Health Evaluation of Active Living Every Day in adults with arthritis Not low back pain, arthritis.
2014 Spine The effect of work-focused rehabilitation among patients with neck and back pain: a Not only low back pain, neck and thoracic
randomised controlled trial spine.
2014 Fisioterapia em Movimento [Physical Impact of dry needling and ischemic pressure in the myofascial syndrome: controlled Not low back pain, myofascial pain
Therapy in Movement] clinical trial syndrome.
2014 The Clinical Journal of Pain Paraspinal stimulation combined with trigger point needling and needle rotation for the Not low back pain, myofascial pain
treatment of myofascial pain: a randomized sham-controlled clinical trial syndrome.
2014 Manual Therapy Manual therapy directed at the knee or lumbopelvic region does not influence quadriceps Not low back pain, knee injury.
spinal reflex excitability
2014 BMC Musculoskeletal Disorders Adverse events after manual therapy among patients seeking care for neck and/or back Not only low back pain, neck and thoracic
pain: a randomized controlled trial spine.
2014 International Journal of Therapeutic Relief from back pain through postural adjustment: a controlled clinical trial of the Not only low back pain, musculoskeletal
Massage and Bodywork immediate effects of muscular chains therapy (MCT) pain in the spine.
2014 PLoS ONE Efficacy of high intensity exercise on disease activity and cardiovascular risk in active axial Not low back pain, axial spondyloarthritis.
spondyloarthritis: a randomized controlled pilot study

10.e3
(continued on next page)
 10.e4
(continued )
Year Journal Title Reason for exclusion
2014 Health Psychology Can we improve cognitive-behavioral therapy for chronic back pain treatment engagement Not only low back pain, neck and thoracic
and adherence? A controlled trial of tailored versus standard therapy spine.
2014 Rheumatology International Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial Not low back pain, ankylosing spondylitis.
2014 Acupuncture in Medicine Efficacy and safety of auriculopressure for primary care patients with chronic non-specific Not only low back pain, neck and thoracic
spinal pain: a multicentre randomised controlled trial spine.
2015 Clinical Rehabilitation Inspiratory muscle training improves aerobic capacity and pulmonary function in patients Not low back pain, ankylosing spondylitis.
with ankylosing spondylitis: a randomized controlled study
2015 Occupational Therapy International Effect of an exercise programme for the prevention of back and neck pain in poultry Not only low back pain, neck and thoracic
slaughterhouse workers spine.
2015 European Journal of Physical and McKenzie training in patients with early stages of ankylosing spondylitis: results of a 24- Not low back pain, ankylosing spondylitis.
Rehabilitation Medicine week controlled study
2015 Medicina Clinica Efectos de un programa de ejercicio fisico y relajacion en el medio acuatico en pacientes Not low back pain, spondyloarthritis.
con espondiloartritis: ensayo clinico aleatorizado
2015 Scandinavian Journal of Work, Effect of workplace- versus home-based physical exercise on musculoskeletal pain among Not low back pain, musculoskeletal pain
Environment & Health healthcare workers: a cluster randomized controlled trial in general.
2015 BMC Musculoskeletal Disorders Change in pain, disability and influence of fear-avoidance in a work-focused intervention Not only low back pain, neck and thoracic
on neck and back pain: a randomized controlled trial spine.
2015 Evidence-Based Complementary and BEMER therapy combined with physiotherapy in patients with musculoskeletal diseases: a Not low back pain, musculoskeletal
Alternative Medicine randomised, controlled double blind follow-up pilot study injuries.
2015 Scientific Reports Validation of placebo in a manual therapy randomized controlled trial Not low back pain, migraines.
www.archives-pmr.org

D.P. Nascimento et al
Abstracts of low back pain trials
Supplemental Appendix S2
Included Trials
1. Aboagye E, Karlsson ML, Hagberg J, Jensen I. Cost-effectiveness of
early interventions for non-specific low back pain: a randomized
controlled study investigating medical yoga, exercise therapy and
self-care advice. J Rehabil Med 2015 Feb;47(2):167-73.
2. Alayat MS, Atya AM, Ali MM, Shosha TM. Long-term effect of
high-intensity laser therapy in the treatment of patients with chronic
low back pain: a randomized blinded placebo-controlled trial. Lasers
Med Sci 2014 May;29(3):1065-73.
3. Albaladejo C, Kovacs FM, Royuela A, del Pino R, Zamora J, Spanish
Back Pain Research N. The efficacy of a short education program and
a short physiotherapy program for treating low back pain in primary
care: a cluster randomized trial. Spine (Phila Pa 1976) 2010 Mar 1;
35(5):483-96.
4. Albert HB, Manniche C. The efficacy of systematic active conser-
vative treatment for patients with severe sciatica: a single-blind,
randomized, clinical, controlled trial. Spine (Phila Pa 1976) 2012
Apr 1;37(7):531-42.
5. Aleksiev AR. Ten-year follow-up of strengthening versus flexibility
exercises with or without abdominal bracing in recurrent low back
pain. Spine (Phila Pa 1976) 2014 Jun 01;39(13):997-1003.
6. Alp AMG, Avsaroglu AH, Mert M, Sigirli D. Efficacy of core-
stabilization exercise and its comparison with home-based conven-
tional exercise in low back pain patients. Turkiye Fiziksel Tip ve
Rehabilitasyon Dergisi [Turkish Journal of Physical Medicine and
Rehabilitation] 2014;60(1):S36-42.
7. Aluko A, DeSouza L, Peacock J. The effect of core stability exercises
on variations in acceleration of trunk movement, pain, and disability
during an episode of acute nonspecific low back pain: a pilot clinical
trial. J Manipulative Physiol Ther 2013 Oct;36(8):497-504 e1-3.
8. Apeldoorn AT, Bosmans JE, Ostelo RW, de Vet HC, van Tulder MW.
Cost-effectiveness of a classification-based system for sub-acute and
chronic low back pain. Eur Spine J 2012 Jul;21(7):1290-300.
9. Apeldoorn AT, Ostelo RW, van Helvoirt H, Fritz JM, Knol DL, van
Tulder MW, et al. A randomized controlled trial on the effectiveness
of a classification-based system for subacute and chronic low back
pain. Spine (Phila Pa 1976) 2012 Jul 15;37(16):1347-56.
10. Bajaj S, Chitra K, Shallu S. Comparison of real-time ultrasound
imaging and pressure biofeedback training for performing abdominal
drawing-in maneuver in low back pain. Indian J Physiother Occup
Ther 2010;4(2):61-5.
11. Becker A, Held H, Redaelli M, Chenot JF, Leonhardt C, Keller S,
et al. Implementation of a guideline for low back pain management in
primary care: a cost-effectiveness analysis. Spine (Phila Pa 1976)
2012 Apr 15;37(8):701-10.
12. Bello AI, Kalu NH, Adegoke BOA, Agyepong-Badu S. Hydrotherapy
versus land-based exercises in the management of chronic low back
pain: a comparative study. J Musculoskelet Res 2010;13(159).
13. Bi X, Zhao J, Zhao L, Liu Z, Zhang J, Sun D, et al. Pelvic floor
muscle exercise for chronic low back pain. J Int Med Res 2013 Feb;
41(1):146-52.
14. Bronfort G, Hondras MA, Schulz CA, Evans RL, Long CR, Grimm R.
Spinal manipulation and home exercise with advice for subacute and
chronic back-related leg pain: a trial with adaptive allocation. Ann
Intern Med 2014 Sep 16;161(6):381-91.
15. Bronfort G, Maiers MJ, Evans RL, Schulz CA, Bracha Y,
Svendsen KH, et al. Supervised exercise, spinal manipulation, and
home exercise for chronic low back pain: a randomized clinical trial.
Spine J 2011 Jul;11(7):585-98.
16. Bruce-Low S, Smith D, Burnet S, Fisher J, Bissell G, Webster L. One
lumbar extension training session per week is sufficient for strength
gains and reductions in pain in patients with chronic low back pain
ergonomics. Ergonomics 2012;55(4):500-7.
www.archives-pmr.org
10.e5
17. Cambron JA, Schneider M, Dexheimer JM, Iannelli G, Chang M,
Terhorst L, et al. A pilot randomized controlled trial of flexion-
distraction dosage for chiropractic treatment of lumbar spinal steno-
sis. J Manipulative Physiol Ther 2014 Jul-Aug;37(6):396-406.
18. Campello M, Ziemke G, Hiebert R, Weiser S, Brinkmeyer M, Fox B,
et al. Implementation of a multidisciplinary program for active duty
personnel seeking care for low back pain in a U.S. Navy Medical
Center: a feasibility study. Mil Med 2012 Sep;177(9):1075-80.
19. Cecchi F, Negrini S, Pasquini G, Paperini A, Conti AA, Chiti M, et al.
Predictors of functional outcome in patients with chronic low back
pain undergoing back school, individual physiotherapy or spinal
manipulation. Eur J Phys Rehabil Med 2012 Sep;48(3):371-8.
20. Chan CW, Mok NW, Yeung EW. Aerobic exercise training in
addition to conventional physiotherapy for chronic low back pain: a
randomized controlled trial. Arch Phys Med Rehabil 2011 Oct;
92(10):1681-5.
21. Chen CY, Chang CW, Lee ST, Chen YC, Tang SF, Cheng CH, et al. Is
rehabilitation intervention during hospitalization enough for func-
tional improvements in patients undergoing lumbar decompression
surgery? A prospective randomized controlled study. Clin Neurol
Neurosurg 2015 Feb;129(Suppl 1):S41-6.
22. Chen M, Chen R, Xiong J, Chi Z, Sun J, Su T, et al. Evaluation of
different moxibustion doses for lumbar disc herniation: multicentre
randomised controlled trial of heat-sensitive moxibustion therapy.
Acupunct Med 2012 Dec;30(4):266-72.
23. Chiauzzi E, Pujol LA, Wood M, Bond K, Black R, Yiu E, et al.
painACTION-back pain: a self-management website for people with
chronic back pain. Pain Med 2010 Jul;11(7):1044-58.
24. Cho YK, Kim DY, Jung SY, Seong JH. Synergistic effect of a reha-
bilitation program and treadmill exercise on pain and dysfunction in
patients with chronic low back pain. J Phys Ther Sci 2015 Apr;27(4):
1187-90.
25. Christiansen S, Oettingen G, Dahme B, Klinger R. A short goal-
pursuit intervention to improve physical capacity: a randomized
clinical trial in chronic back pain patients. Pain 2010 Jun;149(3):
444-52.
26. Chuang LH, Soares MO, Tilbrook H, Cox H, Hewitt CE, Aplin J,
et al. A pragmatic multicentered randomized controlled trial of yoga
for chronic low back pain: economic evaluation. Spine (Phila Pa
1976) 2012 Aug 15;37(18):1593-601.
27. Cramer GD, Cambron J, Cantu JA, Dexheimer JM, Pocius JD,
Gregerson D, et al. Magnetic resonance imaging zygapophyseal joint
space changes (gapping) in low back pain patients following spinal
manipulation and side-posture positioning: a randomized controlled
mechanisms trial with blinding. J Manipulative Physiol Ther 2013
May;36(4):203-17.
28. Cruz-Diaz D, Martinez-Amat A, Osuna-Perez MC, De la Torre-
Cruz MJ, Hita-Contreras F. Short- and long-term effects of a six-week
clinical Pilates program in addition to physical therapy on post-
menopausal women with chronic low back pain: a randomized
controlled trial. Disabil Rehabil 2016;38(13):1300-8.
29. CSG M, PC D, FM A. Efeito do isostretching na resistência muscular
de abdominais, glúteo máximo e extensores de tronco, incapacidade e
dor em pacientes com lombalgia (The Isostretching effect in the
muscle strength of gluteus maximus, abdominal and the trunk
extensor, incapacity and pain in patients with low back pain). Fisio-
terapia em Movimento 2010;23(1).
30. Cuesta-Vargas AI, Adams N, Salazar JA, Belles A, Hazanas S,
Arroyo-Morales M. Deep water running and general practice in pri-
mary care for non-specific low back pain versus general practice
alone: randomized controlled trial. Clin Rheumatol 2012 Jul;31(7):
1073-8.
31. Cuesta-Vargas AI, Garcia-Romero JC, Arroyo-Morales M, Diego-
Acosta AM, Daly DJ. Exercise, manual therapy, and education with
or without high-intensity deep-water running for nonspecific chronic
low back pain: a pragmatic randomized controlled trial. Am J Phys
Med Rehabil 2011 Jul;90(7):526-34. quiz 35-8.
10.e6
32. de Oliveira RF, Liebano RE, Costa Lda C, Rissato LL, Costa LO.
Immediate effects of region-specific and non-region-specific spinal
manipulative therapy in patients with chronic low back pain: a ran-
domized controlled trial. Phys Ther 2013 Jun;93(6):748-56.
33. del Pozo-Cruz B, del Pozo-Cruz J, Adsuar JC, Parraca J, Gusi N.
Reanalysis of a tailored web-based exercise programme for office
workers with sub-acute low back pain: assessing the stage of change
in behaviour. Psychol Health Med 2013;18(6):687-97.
34. del Pozo-Cruz B, Gusi N, del Pozo-Cruz J, Adsuar JC, Hernandez-
Mocholi M, Parraca JA. Clinical effects of a nine-month web-based
intervention in subacute non-specific low back pain patients: a ran-
domized controlled trial. Clin Rehabil 2013 Jan;27(1):28-39.
35. del Pozo-Cruz B, Hernandez Mocholi MA, Adsuar JC, Parraca JA,
Muro I, Gusi N. Effects of whole body vibration therapy on main
outcome measures for chronic non-specific low back pain: a single-blind
randomized controlled trial. J Rehabil Med 2011 Jul;43(8):689-94.
36. del Pozo-Cruz B, Parraca JA, del Pozo-Cruz J, Adsuar JC, Hill J,
Gusi N. An occupational, internet-based intervention to prevent
chronicity in subacute lower back pain: a randomised controlled trial.
J Rehabil Med 2012 Jun;44(7):581-7.
37. Demir S, Dulgeroglu D, Cakci A. Effects of dynamic lumbar stabi-
lization exercises following lumbar microdiscectomy on pain,
mobility and return to work. Randomized controlled trial. Eur J Phys
Rehabil Med 2014 Dec;50(6):627-40.
38. Dogan M, Sahin O, Elden H, Hayta E, Kaptanoglu E. Additional
therapeutic effect of balneotherapy in low back pain. South Med J
2011 Aug;104(8):574-8.
39. Dougherty PE, Karuza J, Dunn AS, Savino D, Katz P. Spinal
Manipulative Therapy for Chronic Lower Back Pain in Older Veter-
ans: A Prospective, Randomized, Placebo-Controlled Trial. Geriatr
Orthop Surg Rehabil 2014 Dec;5(4):154-64.
40. Eadie J, van de Water AT, Lonsdale C, Tully MA, van Mechelen W,
Boreham CA, et al. Physiotherapy for sleep disturbance in people
with chronic low back pain: results of a feasibility randomized
controlled trial. Arch Phys Med Rehabil 2013 Nov;94(11):2083-92.
41. Ebadi S, Ansari NN, Naghdi S, Jalaei S, Sadat M, Bagheri H, et al.
The effect of continuous ultrasound on chronic non-specific low back
pain: a single blind placebo-controlled randomized trial. BMC Mus-
culoskelet Disord 2012;13:192.
42. Facci LM, Nowotny JP, Tormem F, Trevisani VF. Effects of trans-
cutaneous electrical nerve stimulation (TENS) and interferential
currents (IFC) in patients with nonspecific chronic low back pain:
randomized clinical trial. Sao Paulo Med J 2011;129(4):206-16.
43. Fatemi R, Javid M, Najafabadi EM. Effects of William training on
lumbosacral muscles function, lumbar curve and pain. J Back Mus-
culoskelet Rehabil 2015;28(3):591-7.
44. Ferrari R. Effect of a pain diary use on recovery from acute low back
(lumbar) sprain. Rheumatol Int 2015 Jan;35(1):55-9.
45. Fiore P, Panza F, Cassatella G, Russo A, Frisardi V, Solfrizzi V, et al.
Short-term effects of high-intensity laser therapy versus ultrasound
therapy in the treatment of low back pain: a randomized controlled
trial. Eur J Phys Rehabil Med 2011 Sep;47(3):367-73.
46. Flack NA, Hay-Smith EJ, Stringer MD, Gray AR, Woodley SJ.
Adherence, tolerance and effectiveness of two different pelvic support
belts as a treatment for pregnancy-related symphyseal pain - a pilot
randomized trial. BMC Pregnancy Childbirth 2015 Feb 15;15:36.
47. Ford JJ, Hahne AJ, Surkitt LD, Chan AY, Richards MC, Slater SL,
et al. Individualised physiotherapy as an adjunct to guideline-based
advice for low back disorders in primary care: a randomised
controlled trial. Br J Sports Med 2016 Feb;50(4):237-45.
48. Franca FR, Burke TN, Caffaro RR, Ramos LA, Marques AP. Effects
of muscular stretching and segmental stabilization on functional
disability and pain in patients with chronic low back pain: a ran-
domized, controlled trial. J Manipulative Physiol Ther 2012 May;
35(4):279-85.
49. Franca FR, Burke TN, Hanada ES, Marques AP. Segmental stabili-
zation and muscular strengthening in chronic low back pain: a
comparative study. Clinics (Sao Paulo) 2010;65(10):1013-7.
D.P. Nascimento et al
50. Fritz JM, Magel JS, McFadden M, Asche C, Thackeray A, Meier W,
et al. Early Physical Therapy vs Usual Care in Patients With Recent-
Onset Low Back Pain: A Randomized Clinical Trial. JAMA 2015 Oct
13;314(14):1459-67.
51. Froholdt A, Holm I, Keller A, Gunderson RB, Reikeraas O, Brox JI.
No difference in long-term trunk muscle strength, cross-sectional
area, and density in patients with chronic low back pain 7 to 11
years after lumbar fusion versus cognitive intervention and exercises.
Spine J 2011 Aug;11(8):718-25.
52. Ganesh GS, Chhabra D, Pattnaik M, Mohanty P, Patel R, Mrityunjay K.
Effect of trunk muscles training using a star excursion balance test grid
on strength, endurance and disability in persons with chronic low back
pain. J Back Musculoskelet Rehabil 2015;28(3):521-30.
53. Garcia AN, Costa Lda C, da Silva TM, Gondo FL, Cyrillo FN,
Costa RA, et al. Effectiveness of back school versus McKenzie ex-
ercises in patients with chronic nonspecific low back pain: a ran-
domized controlled trial. Phys Ther 2013 Jun;93(6):729-47.
54. Garcia AN, Costa Lda C, Hancock M, Costa LO. Identifying Patients
With Chronic Low Back Pain Who Respond Best to Mechanical
Diagnosis and Therapy: Secondary Analysis of a Randomized
Controlled Trial. Phys Ther 2016 May;96(5):623-30.
55. George SZ, Childs JD, Teyhen DS, Wu SS, Wright AC, Dugan JL,
et al. Brief psychosocial education, not core stabilization, reduced
incidence of low back pain: results from the Prevention of Low Back
Pain in the Military (POLM) cluster randomized trial. BMC Med
2011;9:128.
56. Grunnesjo MI, Bogefeldt JP, Blomberg SI, Strender LE,
Svardsudd KF. A randomized controlled trial of the effects of muscle
stretching, manual therapy and steroid injections in addition to ‘stay
active’ care on health-related quality of life in acute or subacute low
back pain. Clin Rehabil 2011 Nov;25(11):999-1010.
57. Gunay SYY, Karadibak D. The effect of the muscle endurance
training on the chronic low back pain. Turk Fizyoterapi ve Rehabil-
itasyon Dergisi [Turkish Journal of Physiotherapy and Rehabilitation]
2014;25(1):28-34.
58. Gupta M. Effectiveness of nerve mobilization in the management of
sciatica. Indian J Physiother Occup Ther 2012;6(2):79-81.
59. Guthrie RJ, Grindstaff TL, Croy T, Ingersoll CD, Saliba SA. The
effect of traditional bridging or suspension-exercise bridging on
lateral abdominal thickness in individuals with low back pain. J Sport
Rehabil 2012 May;21(2):151-60.
60. Gutke A, Sjodahl J, Oberg B. Specific muscle stabilizing as home
exercises for persistent pelvic girdle pain after pregnancy: a ran-
domized, controlled clinical trial. J Rehabil Med 2010 Nov;42(10):
929-35.
61. Haakstad LA, Bo K. Effect of a regular exercise programme on pelvic
girdle and low back pain in previously inactive pregnant women: A
randomized controlled trial. J Rehabil Med 2015 Mar;47(3):229-34.
62. Haas M, Vavrek D, Peterson D, Polissar N, Neradilek MB. Dose-
response and efficacy of spinal manipulation for care of chronic low
back pain: a randomized controlled trial. Spine J 2014 Jul 01;14(7):
1106-16.
63. Han GCM, Nam G, Moon T, Kim J, Kim S, Hong S, Cho B. The
effects on muscle strength and visual analog scale pain of aquatic
therapy for individuals with low back pain. Journal of Physical
Therapy Science 2011;23(1):57-60.
64. Hartvigsen J, Morso L, Bendix T, Manniche C. Supervised and non-
supervised Nordic walking in the treatment of chronic low back pain:
a single blind randomized clinical trial. BMC Musculoskelet Disord
2010;11:30.
65. Hasegawa TM, Baptista AS, de Souza MC, Yoshizumi AM, Natour J.
Acupuncture for acute non-specific low back pain: a randomised,
controlled, double-blind, placebo trial. Acupunct Med 2014 Apr;
32(2):109-15.
66. Hellum C, Johnsen LG, Storheim K, Nygaard OP, Brox JI, Rossvoll I,
et al. Surgery with disc prosthesis versus rehabilitation in patients
with low back pain and degenerative disc: two year follow-up of
randomised study. BMJ 2011 May 19;342:d2786.
www.archives-pmr.org
Abstracts of low back pain trials
67. Henchoz Y, de Goumoens P, Norberg M, Paillex R, So AK. Role of
physical exercise in low back pain rehabilitation: a randomized
controlled trial of a three-month exercise program in patients who
have completed multidisciplinary rehabilitation. Spine (Phila Pa
1976) 2010 May 20;35(12):1192-9.
68. Henchoz Y, de Goumoens P, So AK, Paillex R. Functional multidis-
ciplinary rehabilitation versus outpatient physiotherapy for non spe-
cific low back pain: randomized controlled trial. Swiss Med Wkly
2010;140:w13133.
69. Henry SM, Van Dillen LR, Ouellette-Morton RH, Hitt JR,
Lomond KV, DeSarno MJ, et al. Outcomes are not different for
patient-matched versus nonmatched treatment in subjects with
chronic recurrent low back pain: a randomized clinical trial. Spine J
2014 Dec 01;14(12):2799-810.
70. Hidalgo B, Pitance L, Hall T, Detrembleur C, Nielens H. Short-term
effects of Mulligan mobilization with movement on pain, disability,
and kinematic spinal movements in patients with nonspecific low
back pain: a randomized placebo-controlled trial. J Manipulative
Physiol Ther 2015 Jul-Aug;38(6):365-74.
71. Hill JJ, Keating JL. Daily exercises and education for preventing low
back pain in children: cluster randomized controlled trial. Phys Ther
2015 Apr;95(4):507-16.
72. Hoffman SL, Johnson MB, Zou D, Harris-Hayes M, Van Dillen LR.
Effect of classification-specific treatment on lumbopelvic motion
during hip rotation in people with low back pain. Man Ther 2011
Aug;16(4):344-50.
73. Homayouni KNM, Zaravar F, Zaravar L, Karimian H. Comparison of
the effect of aquatic physical therapy and conventional physical
therapy in patients with lumbar spinal stenosis (a randomized
controlled trial). Journal of Musculoskeletal Research 2015;18(1):
1550002.
74. Hsieh RL, Lee WC. Short-term therapeutic effects of 890-nanometer
light therapy for chronic low back pain: a double-blind randomized
placebo-controlled study. Lasers Med Sci 2014 Mar;29(2):671-9.
75. Huber J, Lisinski P, Samborski W, Wytrazek M. The effect of early
isometric exercises on clinical and neurophysiological parameters in
patients with sciatica: an interventional randomized single-blinded
study. Isokinet and Exerc Sci 2011;19(3):207-14.
76. Hugli AS, Ernst MJ, Kool J, Rast FM, Rausch-Osthoff AK,
Mannig A, et al. Adherence to home exercises in non-specific low
back pain. A randomised controlled pilot trial. J Bodyw Mov Ther
2015 Jan;19(1):177-85.
77. Hurley DA, Tully MA, Lonsdale C, Boreham CA, van Mechelen W,
Daly L, et al. Supervised walking in comparison with fitness training
for chronic back pain in physiotherapy: results of the SWIFT single-
blinded randomized controlled trial (ISRCTN17592092). Pain 2015
Jan;156(1):131-47.
78. Hwang JA, Bae SH, Do Kim G, Kim KY. The effects of sensorimotor
training on anticipatory postural adjustment of the trunk in chronic
low back pain patients. J Phys Ther Sci 2013 Sep;25(9):1189-92.
79. Jacobson EE, Meleger AL, Bonato P, Wayne PM, Langevin HM,
Kaptchuk TJ, et al. Structural integration as an adjunct to outpatient
rehabilitation for chronic nonspecific low back pain: a randomized
pilot clinical trial. Evid Based Complement Alternat Med 2015;2015:
813418.
80. Jain R, Hameed UA, Tuteja R. Effectiveness of slump stretching in
comparison to conventional physiotherapy in treatment of subacute
non-radicular low back pain. Indian J Physiother Occup Ther 2012;
6(1):123-6.
81. Jaromi M, Nemeth A, Kranicz J, Laczko T, Betlehem J. Treatment
and ergonomics training of work-related lower back pain and
body posture problems for nurses. J Clin Nurs 2012 Jun;21(11-12):
1776-84.
82. Javadian Y, Akbari M, Talebi G, Taghipour-Darzi M,
Janmohammadi N. Influence of core stability exercise on lumbar
vertebral instability in patients presented with chronic low back pain:
A randomized clinical trial. Caspian J Intern Med 2015 Spring;6(2):
98-102.
www.archives-pmr.org
10.e7
83. Javadian Y, Behtash H, Akbari M, Taghipour-Darzi M, Zekavat H.
The effects of stabilizing exercises on pain and disability of patients
with lumbar segmental instability. J Back Musculoskelet Rehabil
2012;25(3):149-55.
84. Jensen C, Jensen OK, Nielsen CV. Sustainability of return to work in
sick-listed employees with low-back pain. Two-year follow-up in a
randomized clinical trial comparing multidisciplinary and brief
intervention. BMC Musculoskelet Disord 2012;13:156.
85. Jensen RK, Kent P, Hancock M. Do MRI findings identify patients
with chronic low back pain and Modic changes who respond best to
rest or exercise: a subgroup analysis of a randomised controlled trial.
Chiropr Man Therap 2015;23:26.
86. Jensen RK, Leboeuf-Yde C, Wedderkopp N, Sorensen JS,
Manniche C. Rest versus exercise as treatment for patients with low
back pain and Modic changes. A randomized controlled clinical trial.
BMC Med 2012;10:22.
87. Johnsen LG, Hellum C, Storheim K, Nygaard OP, Brox JI, Rossvoll I,
et al. Cost-effectiveness of total disc replacement versus multidisci-
plinary rehabilitation in patients with chronic low back pain: a Nor-
wegian multicenter RCT. Spine (Phila Pa 1976) 2014 Jan 01;39(1):
23-32.
88. Kamali F, Shokri E. The effect of two manipulative therapy tech-
niques and their outcome in patients with sacroiliac joint syndrome. J
Bodyw Mov Ther 2012 Jan;16(1):29-35.
89. Kawu AA, Olawepo A, Salami AO. Facet joints infiltration: a viable
alternative treatment to physiotherapy in patients with low back pain
due to facet joint arthropathy. Niger J Clin Pract 2011 Apr-Jun;14(2):
219-22.
90. Kendall KD, Emery CA, Wiley JP, Ferber R. The effect of the
addition of hip strengthening exercises to a lumbopelvic exercise
programme for the treatment of non-specific low back pain: A ran-
domized controlled trial. J Sci Med Sport 2015 Nov;18(6):626-31.
91. Khatri SMJR, Nitsure P. Effectiveness of coccygeal manipulation in
coccydynia: a randomized control trial. Indian Journal of Physio-
therapy and Occupational Therapy 2010;4(4):93-5.
92. Kim BJAJ, Cho H, Kim D, Kim T, Yoon B. Rehabilitation with
osteopathic manipulative treatment after lumbar disc surgery: a
randomised, controlled pilot study. International Journal of Osteo-
pathic Medicine 2015;18(3):181-8.
93. Kluge J, Hall D, Louw Q, Theron G, Grove D. Specific exercises to
treat pregnancy-related low back pain in a South African population.
Int J Gynaecol Obstet 2011 Jun;113(3):187-91.
94. Kordi R, Abolhasani M, Rostami M, Hantoushzadeh S,
Mansournia MA, Vasheghani-Farahani F. Comparison between the
effect of lumbopelvic belt and home based pelvic stabilizing exercise
on pregnant women with pelvic girdle pain; a randomized controlled
trial. J Back Musculoskelet Rehabil 2013;26(2):133-9.
95. Krammer AHS, Tumilty S. Pulsed electromagnetic energy as an
adjunct to physiotherapy for the treatment of acute low back pain: a
randomised controlled trial. New Zealand Journal of Physiotherapy
2015;43(1):16-22.
96. Kumar SP, Cherian PJ. Efficacy of spinal mobilization in the treat-
ment of patients with lumbar radiculopathy due to disc herniation: a
randomized clinical trial. Int J Neurol 2011;3(2):65-76.
97. Lamb SE, Lall R, Hansen Z, Castelnuovo E, Withers EJ, Nichols V,
et al. A multicentred randomised controlled trial of a primary care-
based cognitive behavioural programme for low back pain. The
Back Skills Training (BeST) trial. Health Technol Assess 2010 Aug;
14(41):1-253. iii-iv.
98. Lara-Palomo IC, Aguilar-Ferrandiz ME, Mataran-Penarrocha GA,
Saavedra-Hernandez M, Granero-Molina J, Fernandez-Sola C, et al.
Short-term effects of interferential current electro-massage in adults
with chronic non-specific low back pain: a randomized controlled
trial. Clin Rehabil 2013 May;27(5):439-49.
99. Lawand P, Lombardi Junior I, Jones A, Sardim C, Ribeiro LH, Natour J.
Effect of a muscle stretching program using the global postural reed-
ucation method for patients with chronic low back pain: A randomized
controlled trial. Joint Bone Spine 2015 Jul;82(4):272-7.
10.e8
100. Learman KE, Showalter C, O’Halloran B, Cook CE. Thrust and
nonthrust manipulation for older adults with low back pain: an
evaluation of pain and disability. J Manipulative Physiol Ther 2013
Jun;36(5):284-91.
101. Lee SH, Kim TH, Lee BH. The effect of abdominal bracing in
combination with low extremity movements on changes in thickness
of abdominal muscles and lumbar strength for low back pain. J Phys
Ther Sci 2014 Jan;26(1):157-60.
102. Lee SW, Kim SY. Effects of hip exercises for chronic low-back
pain patients with lumbar instability. J Phys Ther Sci 2015 Feb;
27(2):345-8.
103. Lewis C, Souvlis T, Sterling M. Strain-Counterstrain therapy com-
bined with exercise is not more effective than exercise alone on pain
and disability in people with acute low back pain: a randomised trial.
J Physiother 2011;57(2):91-8.
104. Licciardone JC, Aryal S. Prevention of progressive back-specific
dysfunction during pregnancy: an assessment of osteopathic manual
treatment based on Cochrane Back Review Group criteria. J Am
Osteopath Assoc 2013 Oct;113(10):728-36.
105. Licciardone JC, Kearns CM, Hodge LM, Bergamini MV. Associa-
tions of cytokine concentrations with key osteopathic lesions and
clinical outcomes in patients with nonspecific chronic low back pain:
results from the OSTEOPATHIC Trial. J Am Osteopath Assoc 2012
Sep;112(9):596-605.
106. Licciardone JC, Minotti DE, Gatchel RJ, Kearns CM, Singh KP.
Osteopathic manual treatment and ultrasound therapy for chronic low
back pain: a randomized controlled trial. Ann Fam Med 2013 Mar-
Apr;11(2):122-9.
107. Lin SF, Chen YJ, Tu HP, Lee CL, Hsieh CL, Wu WL, et al. The
Effects of Extracorporeal Shock Wave Therapy in Patients with
Coccydynia: A Randomized Controlled Trial. PLoS One 2015;
10(11):e0142475.
108. Lomond KV, Henry SM, Hitt JR, DeSarno MJ, Bunn JY. Altered
postural responses persist following physical therapy of general
versus specific trunk exercises in people with low back pain. Man
Ther 2014 Oct;19(5):425-32.
109. Lu T, Song QH, Xu RM, Zhang LY. Effect of Tai Chi exercise in
combination with auricular plaster on patients with lumbar muscle
strain. Int J Clin Exp Med 2015;8(2):2949-53.
110. Lurie JD, Tosteson TD, Tosteson AN, Zhao W, Morgan TS,
Abdu WA, et al. Surgical versus nonoperative treatment for lumbar
disc herniation: eight-year results for the spine patient outcomes
research trial. Spine (Phila Pa 1976) 2014 Jan 01;39(1):3-16.
111. Macedo LG, Latimer J, Maher CG, Hodges PW, McAuley JH,
Nicholas MK, et al. Effect of motor control exercises versus graded
activity in patients with chronic nonspecific low back pain: a ran-
domized controlled trial. Phys Ther 2012 Mar;92(3):363-77.
112. Machado LA, Maher CG, Herbert RD, Clare H, McAuley JH. The
effectiveness of the McKenzie method in addition to first-line care for
acute low back pain: a randomized controlled trial. BMC Med 2010;
8:10.
113. Mannion AF, Brox JI, Fairbank JC. Comparison of spinal fusion and
nonoperative treatment in patients with chronic low back pain: long-
term follow-up of three randomized controlled trials. Spine J 2013
Nov;13(11):1438-48.
114. Masse-Alarie H, Flamand VH, Moffet H, Schneider C. Peripheral
neurostimulation and specific motor training of deep abdominal
muscles improve posturomotor control in chronic low back pain. Clin
J Pain 2013 Sep;29(9):814-23.
115. Mattila VM, Sillanpaa P, Salo T, Laine HJ, Maenpaa H,
Pihlajamaki H. Orthotic insoles do not prevent physical stress-
induced low back pain. Eur Spine J 2011 Jan;20(1):100-4.
116. McGregor AH, Henley A, Morris TP, Dore CJ, team F. An evaluation
of a postoperative rehabilitation program after spinal surgery and its
impact on outcome. Spine (Phila Pa 1976) 2012 Apr 1;37(7):E417-22.
117. McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ.
Manipulation or microdiskectomy for sciatica? A prospective
D.P. Nascimento et al
randomized clinical study. J Manipulative Physiol Ther 2010 Oct;
33(8):576-84.
118. Meng K, Seekatz B, Roband H, Worringen U, Vogel H, Faller H.
Intermediate and long-term effects of a standardized back school for
inpatient orthopedic rehabilitation on illness knowledge and self-
management behaviors: a randomized controlled trial. Clin J Pain
2011 Mar-Apr;27(3):248-57.
119. Miyamoto GC, Costa LO, Galvanin T, Cabral CM. Efficacy of the
addition of modified Pilates exercises to a minimal intervention in
patients with chronic low back pain: a randomized controlled trial.
Phys Ther 2013 Mar;93(3):310-20.
120. Monro R, Bhardwaj AK, Gupta RK, Telles S, Allen B, Little P. Disc
extrusions and bulges in nonspecific low back pain and sciatica:
Exploratory randomised controlled trial comparing yoga therapy and
normal medical treatment. J Back Musculoskelet Rehabil 2015;28(2):
383-92.
121. Monticone M, Ambrosini E, Rocca B, Cazzaniga D, Liquori V,
Foti C. Group-based task-oriented exercises aimed at managing
kinesiophobia improved disability in chronic low back pain. Eur J
Pain 2016 Apr;20(4):541-51.
122. Moon HJ, Choi KH, Kim DH, Kim HJ, Cho YK, Lee KH, et al. Effect
of lumbar stabilization and dynamic lumbar strengthening exercises
in patients with chronic low back pain. Ann Rehabil Med 2013 Feb;
37(1):110-7.
123. Moon TY, Kim JH, Gwon HJ, Hwan BS, Kim GY, Smith N, et al.
Effects of exercise therapy on muscular strength in firefighters with
back pain. J Phys Ther Sci 2015 Mar;27(3):581-3.
124. Moore C, Holland J, Shaib F, Ceridan E, Schonard C, Marasa M.
Prevention of low back pain in sedentary healthy workers: a pilot
study. Am J Med Sci 2012 Aug;344(2):90-5.
125. Morone G, Paolucci T, Alcuri MR, Vulpiani MC, Matano A, Bureca I,
et al. Quality of life improved by multidisciplinary back school
program in patients with chronic non-specific low back pain: a single
blind randomized controlled trial. Eur J Phys Rehabil Med 2011 Dec;
47(4):533-41.
126. Morris S, Morris TP, McGregor AH, Dore CJ, Jamrozik K. Function
after spinal treatment, exercise, and rehabilitation: cost-effectiveness
analysis based on a randomized controlled trial. Spine (Phila Pa
1976) 2011 Oct 1;36(21):1807-14.
127. Naik PP, Heggannavar A, Khatri SM. Comparison of muscle energy
technique and positional release therapy in acute low back pain –
RCT. Indian J Physiother Occup Ther 2010;4(2):32-6.
128. Naqaish TRF, Ambreen S. Efficacy of Kegel exercises on lower back
pain control in patients of Cystocele. Rawal Medical Journal 2013;
38(3):275-8.
129. Nassif H, Brosset N, Guillaume M, Delore-Milles E, Tafflet M,
Buchholz F, et al. Evaluation of a randomized controlled trial in the
management of chronic lower back pain in a French automotive in-
dustry: an observational study. Arch Phys Med Rehabil 2011 Dec;
92(12):1927-36 e4.
130. Natour J, Cazotti Lde A, Ribeiro LH, Baptista AS, Jones A. Pilates
improves pain, function and quality of life in patients with chronic
low back pain: a randomized controlled trial. Clin Rehabil 2015 Jan;
29(1):59-68.
131. Nazzal ME, Saadah MA, Saadah LM, Al-Omari MA, Al-Oudat ZA,
Nazzal MS, et al. Management options of chronic low back pain. A
randomized blinded clinical trial. Neurosciences (Riyadh) 2013 Apr;
18(2):152-9.
132. Nemcic T, Budisin V, Vrabec-Matkovic D, Grazio S. Comparison of
the effects of land-based and water-based therapeutic exercises on the
range of motion and physical disability in patients with chronic low-
back pain: single-blinded randomized study. Acta Clin Croat 2013
Sep;52(3):321-7.
133. Oestergaard LG, Nielsen CV, Bunger CE, Sogaard R, Fruensgaard S,
Helmig P, et al. The effect of early initiation of rehabilitation after
lumbar spinal fusion: a randomized clinical study. Spine (Phila Pa
1976) 2012 Oct 1;37(21):1803-9.
www.archives-pmr.org
Abstracts of low back pain trials
134. Ohtsuki K. The immediate changes in patients with acute exacerba-
tion of chronic lower-back pain elicited by direct stretching of the
tensor fasciae latae, the hamstrings and the adductor magnus. J Phys
Ther Sci 2012;24(8):707-9.
135. Okafor UA, Solanke TA, Akinbo SR, Odebiyi DO. Effect of aerobic
dance on pain, functional disability and quality of life on patients with
chronic low back pain. SAJPA 2012;68(3):11-4.
136. Oke KI, Umebese PF. Evaluation of the efficacy of pulsed electro-
magnetic therapy in the treatment of back pain: a randomized
controlled trial in a tertiary hospital in Nigeria. West Indian Med J
2013 Mar;62(3):205-9.
137. Olmedo-Buenrostro BA, Trujillo-Hernandez B, Perez-Vargas FD,
Diaz-Giner VR, Delgado-Enciso I, Muniz-Murguia J, et al. [Com-
parison of three therapeutic exercises protocols to lumbar hyper-
lordosis improvement in asyntomatic youths]. Rev Invest Clin 2010
Nov-Dec;62(6):568-76.
138. Omar AS, Awadalla MA, El-Latif MA. Evaluation of pulsed
electromagnetic field therapy in the management of patients with
discogenic lumbar radiculopathy. Int J Rheum Dis 2012 Oct;15(5):
e101-8.
139. Onac IAMA, Onac I, Igna R, Pop L. Medication. physiotherapy and
cognitive behavior therapy for the treatment of chronic back pain: a
clinical trial. Journal of Cognitive and Behavioral Psychotherapies
2012;12(1):23-37.
140. Ozdemir S, Bebis H, Ortabag T, Acikel C. Evaluation of the efficacy
of an exercise program for pregnant women with low back and pelvic
pain: a prospective randomized controlled trial. J Adv Nurs 2015 Aug;
71(8):1926-39.
141. Ozkara GO, Ozgen M, Ozkara E, Armagan O, Arslantas A,
Atasoy MA. Effectiveness of physical therapy and rehabilitation
programs starting immediately after lumbar disc surgery. Turk Neu-
rosurg 2015;25(3):372-9.
142. Pach D, Yang-Strobel X, Ludtke R, Roll S, Icke K, Brinkhaus B, et al.
Standardized versus Individualized Acupuncture for Chronic Low
Back Pain: A Randomized Controlled Trial. Evid Based Complement
Alternat Med 2013;2013:125937.
143. Park K, Seo K. The Effects on the Pain Index and Lumbar Flexibility
of Obese Patients with Low Back Pain after PNF Scapular and PNF
Pelvic Patterns. J Phys Ther Sci 2014 Oct;26(10):1571-4.
144. Parreira Pdo C, Costa Lda C, Takahashi R, Hespanhol Junior LC, Luz
Junior MA, Silva TM, et al. Kinesio taping to generate skin convo-
lutions is not better than sham taping for people with chronic non-
speci fi c low back pain: a randomised trial. J Physiother 2014 Jun;
60(2):90-6.
145. Petersen T, Larsen K, Nordsteen J, Olsen S, Fournier G, Jacobsen S.
The McKenzie method compared with manipulation when used
adjunctive to information and advice in low back pain patients pre-
senting with centralization or peripheralization: a randomized
controlled trial. Spine (Phila Pa 1976) 2011 Nov 15;36(24):1999-
2010.
146. Prasert S, Roongtiwa V, Mantana V, Witchate P, Benjawan S. Effects
of physical therapy treatments with and without spinal mobilization in
individuals with acute nonspecific low back pain: A randomized trial.
Indian J Physiother Occup Ther 2010;4(4):107-11.
147. Prommanon B, Puntumetakul R, Puengsuwan P, Chatchawan U,
Kamolrat T, Rittitod T, et al. Effectiveness of a back care pillow as an
adjuvant physical therapy for chronic non-specific low back pain
treatment: a randomized controlled trial. J Phys Ther Sci 2015 Jul;
27(7):2035-8.
148. Pushpika Attanayake AM, Somarathna KI, Vyas GH, Dash SC.
Clinical evaluation of selected Yogic procedures in individuals with
low back pain. Ayu 2010 Apr;31(2):245-50.
149. Ratajczak B, Hawrylak A, Demidas A, Kuciel-Lewandowska J,
Boerner E. Effectiveness of diadynamic currents and transcutaneous
electrical nerve stimulation in disc disease lumbar part of spine. J
Back Musculoskelet Rehabil 2011;24(3):155-9.
150. Rhee HS, Kim YH, Sung PS. A randomized controlled trial to
determine the effect of spinal stabilization exercise intervention based
www.archives-pmr.org
10.e9
on pain level and standing balance differences in patients with low
back pain. Med Sci Monit 2012 Mar;18(3):CR174-81.
151. Riva S, Camerini AL, Allam A, Schulz PJ. Interactive sections of an
Internet-based intervention increase empowerment of chronic back
pain patients: randomized controlled trial. J Med Internet Res 2014
Aug 13;16(8):e180.
152. Rogerson MD, Gatchel RJ, Bierner SM. A cost utility analysis of
interdisciplinary early intervention versus treatment as usual for high-
risk acute low back pain patients. Pain Pract 2010 Sep-Oct;10(5):382-
95.
153. Saliba SA, Croy T, Guthrie R, Grooms D, Weltman A, Grindstaff TL.
Differences in transverse abdominis activation with stable and un-
stable bridging exercises in individuals with low back pain. N Am J
Sports Phys Ther 2010 Jun;5(2):63-73.
154. Saper RB, Boah AR, Keosaian J, Cerrada C, Weinberg J, Sherman KJ.
Comparing Once- versus Twice-Weekly Yoga Classes for Chronic
Low Back Pain in Predominantly Low Income Minorities: A Ran-
domized Dosing Trial. Evid Based Complement Alternat Med 2013;
2013:658030.
155. Selhorst M, Selhorst B. Lumbar manipulation and exercise for the
treatment of acute low back pain in adolescents: a randomized
controlled trial. J Man Manip Ther 2015 Sep;23(4):226-33.
156. Senna MK, Machaly SA. Does maintained spinal manipulation
therapy for chronic nonspecific low back pain result in better long-
term outcome? Spine (Phila Pa 1976) 2011 Aug 15;36(18):1427-37.
157. Sharma V, Sarkari E, Multani NK. Efficacy of neural mobilization in
sciatica. Indian J Physiother Occup Ther 2011;5(1):125-7.
158. Sheeran L, van Deursen R, Caterson B, Sparkes V. Classification-
guided versus generalized postural intervention in subgroups of
nonspecific chronic low back pain: a pragmatic randomized
controlled study. Spine (Phila Pa 1976) 2013 Sep 1;38(19):1613-25.
159. Sherman KJ, Cherkin DC, Wellman RD, Cook AJ, Hawkes RJ,
Delaney K, et al. A randomized trial comparing yoga, stretching, and
a self-care book for chronic low back pain. Arch Intern Med 2011
Dec 12;171(22):2019-26.
160. Shin JS, Ha IH, Lee J, Choi Y, Kim MR, Park BY, et al. Effects of
motion style acupuncture treatment in acute low back pain patients
with severe disability: a multicenter, randomized, controlled,
comparative effectiveness trial. Pain 2013 Jul;154(7):1030-7.
161. Siemonsma PC, Stuive I, Roorda LD, Vollebregt JA, Walker MF,
Lankhorst GJ, et al. Cognitive treatment of illness perceptions in
patients with chronic low back pain: a randomized controlled trial.
Phys Ther 2013 Apr;93(4):435-48.
162. Simmerman SM, Sizer PS, Dedrick GS, Apte GG, Brismee JM. Im-
mediate changes in spinal height and pain after aquatic vertical
traction in patients with persistent low back symptoms: a crossover
clinical trial. PM R 2011 May;3(5):447-57.
163. Sokunbi OGML, Robinson P. A pilot study on using acupuncture and
core stability exercises to treat non-specific South. African Journal of
Physiotherapy 2014;70(2):4-10.
164. Son JH, Park GD, Park HS. The effect of sacroiliac joint mobilization
on pelvic deformation and the static balance ability of female uni-
versity students with si joint dysfunction. J Phys Ther Sci 2014 Jun;
26(6):845-8.
165. Sorensen PH, Bendix T, Manniche C, Korsholm L, Lemvigh D,
Indahl A. An educational approach based on a non-injury model
compared with individual symptom-based physical training in chronic
LBP. A pragmatic, randomised trial with a one-year follow-up. BMC
Musculoskelet Disord 2010;11:212.
166. Suni JH, Taanila H, Mattila VM, Ohrankammen O, Vuorinen P,
Pihlajamaki H, et al. Neuromuscular exercise and counseling decrease
absenteeism due to low back pain in young conscripts: a randomized,
population-based primary prevention study. Spine (Phila Pa 1976)
2013 Mar 1;38(5):375-84.
167. Szlezak AM, Georgilopoulos P, Bullock-Saxton JE, Steele MC. The
immediate effect of unilateral lumbar Z-joint mobilisation on poste-
rior chain neurodynamics: a randomised controlled study. Man Ther
2011 Dec;16(6):609-13.
10.e10
168. Szulc P, Wendt M, Waszak M, Tomczak M, Cieslik K, Trzaska T.
Impact of McKenzie Method Therapy Enriched by Muscular Energy
Techniques on Subjective and Objective Parameters Related to Spine
Function in Patients with Chronic Low Back Pain. Med Sci Monit
2015 Sep 29;21:2918-32.
169. Tavafian SS, Jamshidi AR, Mohammad K. Treatment of chronic low
back pain: a randomized clinical trial comparing multidisciplinary
group-based rehabilitation program and oral drug treatment with oral
drug treatment alone. Clin J Pain 2011 Nov-Dec;27(9):811-8.
170. Tellez-Garcia M, de-la-Llave-Rincon AI, Salom-Moreno J, Palacios-
Cena M, Ortega-Santiago R, Fernandez-de-Las-Penas C. Neurosci-
ence education in addition to trigger point dry needling for the
management of patients with mechanical chronic low back pain: A
preliminary clinical trial. J Bodyw Mov Ther 2015 Jul;19(3):464-72.
171. Tilbrook HE, Cox H, Hewitt CE, Kang’ombe AR, Chuang LH,
Jayakody S, et al. Yoga for chronic low back pain: a randomized trial.
Ann Intern Med 2011 Nov 1;155(9):569-78.
172. Tilbrook HE, Hewitt CE, Aplin JD, Semlyen A, Trewhela A, Watt I,
et al. Compliance effects in a randomised controlled trial of yoga for
chronic low back pain: a methodological study. Physiotherapy 2014
Sep;100(3):256-62.
173. Unsgaard-Tondel M, Fladmark AM, Salvesen O, Vasseljen O. Motor
control exercises, sling exercises, and general exercises for patients
with chronic low back pain: a randomized controlled trial with 1-year
follow-up. Phys Ther 2010 Oct;90(10):1426-40.
174. Vallone F, Benedicenti S, Sorrenti E, Schiavetti I, Angiero F. Effect of
diode laser in the treatment of patients with nonspecific chronic low
back pain: a randomized controlled trial. Photomed Laser Surg 2014
Sep;32(9):490-4.
175. Vasseljen O, Fladmark AM. Abdominal muscle contraction thickness
and function after specific and general exercises: a randomized
controlled trial in chronic low back pain patients. Man Ther 2010 Oct;
15(5):482-9.
176. Verma YGM. Narkeesh. Pain, range of motion and back strength in
chronic mechanical low back pain before and after lumbar mobi-
lisation. International Journal of Physiotherapy and Research
2013;(3):48-57.
177. Vibe Fersum K, O’Sullivan P, Skouen JS, Smith A, Kvale A. Efficacy
of classification-based cognitive functional therapy in patients with
non-specific chronic low back pain: a randomized controlled trial. Eur
J Pain 2013 Jul;17(6):916-28.
178. Vidal J, Borras PA, Ponseti FJ, Cantallops J, Ortega FB, Palou P. Effects
of a postural education program on school backpack habits related to
low back pain in children. Eur Spine J 2013 Apr;22(4):782-7.
179. Vieira-Pellenz F, Oliva-Pascual-Vaca A, Rodriguez-Blanco C,
Heredia-Rizo AM, Ricard F, Almazan-Campos G. Short-term effect
of spinal manipulation on pain perception, spinal mobility, and full
height recovery in male subjects with degenerative disk disease: a
randomized controlled trial. Arch Phys Med Rehabil 2014 Sep;95(9):
1613-9.
180. Vincent HK, Vincent KR, Seay AN, Conrad BP, Hurley RW,
George SZ. Back strength predicts walking improvement in obese,
older adults with chronic low back pain. PM R 2014 May;6(5):418-
26.
181. Vong SK, Cheing GL, Chan F, So EM, Chan CC. Motivational
enhancement therapy in addition to physical therapy improves
motivational factors and treatment outcomes in people with low back
pain: a randomized controlled trial. Arch Phys Med Rehabil 2011
Feb;92(2):176-83.
182. Wajswelner H, Metcalf B, Bennell K. Clinical pilates versus general
exercise for chronic low back pain: randomized trial. Med Sci Sports
Exerc 2012 Jul;44(7):1197-205.
183. Wand BM, Abbaszadeh S, Smith AJ, Catley MJ, Moseley GL.
Acupuncture applied as a sensory discrimination training tool
D.P. Nascimento et al
decreases movement-related pain in patients with chronic low back
pain more than acupuncture alone: a randomised cross-over experi-
ment. Br J Sports Med 2013 Nov;47(17):1085-9.
184. Wand BM, Tulloch VM, George PJ, Smith AJ, Goucke R,
O’Connell NE, et al. Seeing it helps: movement-related back pain is
reduced by visualization of the back during movement. Clin J Pain
2012 Sep;28(7):602-8.
185. Weiss J, Quante S, Xue F, Muche R, Reuss-Borst M. Effectiveness
and acceptance of acupuncture in patients with chronic low back pain:
results of a prospective, randomized, controlled trial. J Altern Com-
plement Med 2013 Dec;19(12):935-41.
186. Xia ZXYL, Zhang Y. Effect of auricular point sticking on pain due to
lumbar strain. Journal of Acupuncture and Tuina Science 2011;9(6):
384-7.
187. Yardley L, Dennison L, Coker R, Webley F, Middleton K, Barnett J,
et al. Patients’ views of receiving lessons in the Alexander technique
and an exercise prescription for managing back pain in the ATEAM
trial. Fam Pract 2010 Apr;27(2):198-204.
188. Yeh ML, Chung YC, Chen KM, Chen HH. Pain reduction of acupoint
electrical stimulation for patients with spinal surgery: a placebo-
controlled study. Int J Nurs Stud 2011 Jun;48(6):703-9.
189. Yeh ML, Tsou MY, Lee BY, Chen HH, Chung YC. Effects of
auricular acupressure on pain reduction in patient-controlled anal-
gesia after lumbar spine surgery. Acta Anaesthesiol Taiwan 2010 Jun;
48(2):80-6.
190. Yildirim Y, Soyunov S. Relationship between learning strategies of
patients and proper perception of the home exercise program with
non-specific low back pain. J Back Musculoskelet Rehabil 2010;
23(3):137-42.
191. Yoo JH, Kim SE, Lee MG, Jin JJ, Hong J, Choi YT, et al. The effect
of horse simulator riding on visual analogue scale, body composition
and trunk strength in the patients with chronic low back pain. Int J
Clin Pract 2014 Aug;68(8):941-9.
192. Yoon YS, Yu KP, Lee KJ, Kwak SH, Kim JY. Development and
application of a newly designed massage instrument for deep cross-
friction massage in chronic non-specific low back pain. Ann Reha-
bil Med 2012 Feb;36(1):55-65.
193. You JH, Kim SY, Oh DW, Chon SC. The effect of a novel core sta-
bilization technique on managing patients with chronic low back
pain: a randomized, controlled, experimenter-blinded study. Clin
Rehabil 2014 May;28(5):460-9.
194. You YL, Su TK, Liaw LJ, Wu WL, Chu IH, Guo LY. The effect of six
weeks of sling exercise training on trunk muscular strength and
endurance for clients with low back pain. J Phys Ther Sci 2015 Aug;
27(8):2591-6.
195. Yuan WA, Huang SR, Guo K, Sun WQ, Xi XB, Zhang MC, et al.
Integrative TCM Conservative Therapy for Low Back Pain due to
Lumbar Disc Herniation: A Randomized Controlled Clinical Trial.
Evid Based Complement Alternat Med 2013;2013:309831.
196. Yun M, Shao Y, Zhang Y, He S, Xiong N, Zhang J, et al. Hegu
acupuncture for chronic low-back pain: a randomized controlled trial.
J Altern Complement Med 2012 Feb;18(2):130-6.
197. Zahari ZKK, Othman IR, Justine M. Effect of patient education
combined with physiotherapy treatment on fear-avoidance belief in
low back pain sufferers. International Journal of Pharma and Bio
Sciences 2014;5(2):B640-8.
198. Zaringhalam J, Manaheji H, Rastqar A, Zaringhalam M. Reduction of
chronic non-specific low back pain: a randomised controlled clinical
trial on acupuncture and baclofen. Chin Med 2010;5:15.
199. Zhang Y, Wan L, Wang X. The effect of health education in patients
with chronic low back pain. J Int Med Res 2014 Jun;42(3):815-20.
200. Zheng Z, Wang J, Gao Q, Hou J, Ma L, Jiang C, et al. Therapeutic
evaluation of lumbar tender point deep massage for chronic non-
specific low back pain. J Tradit Chin Med 2012 Dec;32(4). 534-7.
www.archives-pmr.org
Abstracts of low back pain trials 10.e11

Supplemental Appendix S3
Percentage of trials per journal, 2015 impact factor, CONSORT
recommendations endorsement and open access journals (nZ200).

Impact Endorses CONSORT Open Access

Item Journal Percentage (%) Factor 2015 Recommendations Journals
1 Acta Anaesthesiologica Taiwanica 0.5 Not reported Yes Yes
2 Acta Clinica Croatica 0.5 0,412 No No
3 Acupuncture in Medicine 1.0 1,592 Yes No
4 American Journal of Physical Medicine & Rehabilitation 0.5 2,064 Yes No
5 An International Quarterly Journal of Research in Ayurveda 0.5 Not reported Yes Yes
6 Annals of Family Medicine 0.5 5,087 Yes Yes
7 Annals of Internal Medicine 1.0 16,440 Yes No
8 Annals of Rehabilitation Medicine 1.0 Not reported Yes Yes
9 Archives of Internal Medicine 0.5 Not reported Yes Yes
10 Archives of Physical Medicine and Rehabilitation 2.5 3,045 Yes No
11 BMC Medicine 1.5 8,005 Yes Yes
12 BMC Musculoskeletal Disorders 2.0 1,684 Yes Yes
13 BMC Pregnancy and Childbirth 0.5 2,180 Yes Yes
14 British Journal of Sports Medicine 1.0 6,724 No No
15 British Medical Journal 0.5 19,697 Yes No
16 Caspian Journal of Internal Medicine 0.5 Not reported No Yes
17 Chinese Medicine 0.5 1,580 Yes Yes
18 Chiropractic & Manual Therapies 0.5 Not reported Yes Yes
19 Chung I Tsa Chih Ying Wen Pan [Journal of Traditional 0.5 1,023 Yes Yes
Chinese Medicine]
20 Clinical Neurology and Neurosurgery 0.5 1,198 No No
21 Clinical Rehabilitation 2.5 2,403 No No
22 Clinical Rheumatology 0.5 2,042 No No
23 Clinics 0.5 1,328 No Yes
24 Disability and Rehabilitation 0.5 1,919 No No
25 Ergonomics 0.5 1,449 No No
26 European Journal of Pain 1.0 2,900 Yes No
27 European Journal of Physical and Rehabilitation Medicine 2.0 2,063 Yes Yes
28 European Spine Journal 1.5 2,132 No No
29 Evidence-Based Complementary and Alternative Medicine 2.0 1,931 No Yes
30 Family Practice 0.5 2,022 Yes No
31 Fisioterapia em movimento 0.5 Not reported No No
32 Geriatric Orthopaedic Surgery & Rehabilitation 0.5 Not reported Yes Yes
33 Health Technology Assessment 0.5 4,058 Yes Yes
34 Indian Journal of Physiotherapy and Occupational Therapy 3.5 1,166 No No
35 International Journal of Clinical and Experimental Medicine 0.5 1,075 No Yes
36 International Journal of Clinical Practice 0.5 2,226 Yes No
37 International Journal of Gynaecology and Obstetrics 0.5 1,674 Yes No
38 International Journal of Neurology and Neurosurgery 0.5 Not reported No No
39 International Journal of Nursing Studies 0.5 3,561 Yes No
40 International Journal of Osteopathic Medicine 0.5 0,509 Yes Yes
41 International Journal of Pharma and Bio Sciences 0.5 Not reported No Yes
42 International Journal of Physiotherapy and Research 0.5 Not reported No Yes
43 International Journal of Rheumatic Diseases 0.5 1,914 No No
44 International Journal of Sports Physical Therapy 0.5 Not reported Yes Yes
45 Isokinetics and Exercise Science 0.5 0,357 No No
46 Joint, Bone, Spine 0.5 Not reported No No
47 Journal of Acupuncture and Tuina Science 0.5 Not reported No No
48 Journal of Advanced Nursing 0.5 1,917 Yes No
49 Journal of Alternative & Complementary Medicine 1.0 1,395 Yes No
50 Journal of Back and Musculoskeletal Rehabilitation 3.5 0,956 No No
(continued on next page)

www.archives-pmr.org
10.e12 D.P. Nascimento et al

(continued )
Impact Endorses CONSORT Open Access
Item Journal Percentage (%) Factor 2015 Recommendations Journals
51 Journal of Bodywork and Movement Therapies 1.5 Not reported No No
52 Journal of Clinical Nursing 0.5 1,384 Yes No
53 Journal of Cognitive and Behavioral Psychotherapies 0.5 Not reported No No
54 Journal of Manipulative and Physiological Therapeutics 3.5 1,329 Yes No
55 Journal of Medical Internet Research 0.5 4,532 Yes Yes
56 Journal of Musculoskeletal Research 1.0 Not reported No No
57 Journal of Physical Therapy Science 5.5 Not reported No Yes
58 Journal of Physiotherapy 1.0 4,000 Yes Yes
59 Journal of Rehabilitation Medicine 2.5 1,595 Yes Yes
60 Journal of Science and Medicine in Sport 0.5 3,756 No No
61 Journal of Sport Rehabilitation 0.5 1,612 No No
62 Lasers in Medical Science 1.0 2,461 No No
63 Manual Therapy 2.0 1,869 Yes No
64 Medical Science Monitor 1.0 1,405 No No
65 Medicine and Science in Sports and Exercise 0.5 4,041 No No
66 Military Medicine 0.5 0,969 Yes No
67 Neurosciences 0.5 0,541 Yes Yes
68 New Zealand Journal of Physiotherapy 0.5 Not reported No No
69 Nigerian Journal of Clinical Practice 0.5 0,524 Yes Yes
70 Pain 1.5 5,557 Yes No
71 Pain Medicine 0.5 2,324 No No
72 Pain Practice 0.5 2,317 Yes No
73 Photomedicine and Laser Surgery 0.5 1,631 No No
74 Physical Therapy 4.0 2,779 Yes No
75 Physiotherapy 0.5 1,814 Yes No
76 PLoS ONE 0.5 3,057 Yes Yes
77 PM&R 1.0 1,655 Yes No
78 Psychology, Health & Medicine 0.5 1,347 No No
79 Rawal Medical Journal 0.5 Not reported No Yes
80 Revista de Investigacion Clinica 0.5 0,477 No No
81 Revista Paulista de Medicina [Sao Paulo Medical Journal] 0.5 0,955 Yes Yes
82 Rheumatology International 0.5 1,702 Yes No
83 South African Journal of Physiotherapy 1.0 Not reported No Yes
84 Southern Medical Journal 0.5 0,882 No No
85 Spine 8.0 2,439 Yes No
86 Swiss Medical Weekly 0.5 1,549 No Yes
87 The American Journal of the Medical Sciences 0.5 1,757 No No
88 The Clinical Journal of Pain 2.0 2,712 No No
89 The Journal of International Medical Research 1.0 1,431 Yes No
90 The Journal of Manual & Manipulative Therapy 0.5 Not reported No Yes
91 The Journal of the American Medical Association 0.5 Not reported Yes No
92 The Journal of the American Osteopathic Association 1.0 Not reported No No
93 The Spine Journal 2.5 2,660 Yes No
94 The West Indian Medical Journal 0.5 Not reported No No
95 Turk Fizyoterapi ve Rehabilitasyon Dergisi [Turkish Journal 0.5 Not reported No Yes
of Physiotherapy and Rehabilitation]
96 Turkish Neurosurgery 0.5 0,508 Yes Yes
97 Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi 0.5 Not reported No Yes
[Turkish Journal of
Physical Medicine and Rehabilitation]

www.archives-pmr.org
Abstracts of low back pain trials 10.e13

Supplemental Appendix S4
Methodologic quality of the 200 trials, measured by the PEDro
scale [44, 45]. Data presented for the total PEDro score.

First Author Year Journal Total PEDro Score 0/10

Aboagye 2015 Journal of Rehabilitation Medicine 6
Alayat 2014 Lasers in Medical Science 5
Albaladejo 2010 Spine 7
Albert 2012 Spine 7
Aleksiev 2014 Spine 4
Alp 2014 Turkish Journal of Physical Medicine and Rehabilitation 6
Aluko 2013 Journal of Manipulative and Physiological Therapeutics 7
Apeldoorn 2012 European Spine Journal 7
Apeldoorn 2012 Spine 8
Bajaj 2010 Indian Journal of Physiotherapy and Occupational Therapy 5
Becker 2012 Spine 7
Bello 2010 Journal of Musculoskeletal Research 4
Bi 2013 The Journal of International Medical Research 7
Bronfort 2014 Annals of Internal Medicine 8
Bronfort 2011 The Spine Journal 8
Bruce-Low 2012 Ergonomics 5
Cambron 2014 Journal of Manipulative and Physiological Therapeutics 6
Campello 2012 Military Medicine 6
Cecchi 2012 European Journal of Physical and Rehabilitation Medicine 4
Chan 2011 Archives of Physical Medicine and Rehabilitation 7
Chen 2015 Clinical Neurology and Neurosurgery 6
Chen 2012 Acupuncture in Medicine 8
Chiauzzi 2010 Pain Medicine 6
Cho 2015 Journal of Physical Therapy Science 4
Christiansen 2010 Pain 6
Chuang 2012 Spine 5
Cramer 2013 Journal of Manipulative and Physiological Therapeutics 5
Cruz-Diaz 2015 Disability and Rehabilitation 8
Cuesta-Vargas 2012 Clinical Rheumatology 8
Cuesta-Vargas 2011 American Journal of Physical Medicine & Rehabilitation 6
de Oliveira 2013 Physical Therapy 8
del Pozo-Cruz 2013 Psychology, Health & Medicine 4
del Pozo-Cruz 2013 Clinical Rehabilitation 5
del Pozo-Cruz 2011 Journal of Rehabilitation Medicine 7
del Pozo-Cruz 2012 Journal of Rehabilitation Medicine 7
Demir 2014 European Journal of Physical and Rehabilitation Medicine 4
Dogan 2011 Southern Medical Journal 5
Dougherty 2014 Geriatric Orthopaedic Surgery & Rehabilitation 8
Eadie 2013 Archives of Physical Medicine and Rehabilitation 7
Ebadi 2012 BMC Musculoskeletal Disorders 8
Facci 2011 Sao Paulo Medical Journal 7
Fatemi 2015 Journal of Back and Musculoskeletal Rehabilitation 4
Ferrari 2015 Rheumatology International 5
Fiore 2011 European Journal of Physical and Rehabilitation Medicine 4
Flack 2015 BMC Pregnancy and Childbirth 6
Ford 2015 British Journal of Sports Medicine 6
Franca 2012 Journal of Manipulative and Physiological Therapeutics 4
Franca 2010 Clinics 7
Fritz 2015 The Journal of the American Medical Association 8
Froholdt 2011 The Spine Journal 6
Ganesh 2015 Journal of Back and Musculoskeletal Rehabilitation 5
(continued on next page)

www.archives-pmr.org
10.e14 D.P. Nascimento et al

(continued )
First Author Year Journal Total PEDro Score 0/10
Garcia 2013 Physical Therapy 6
Garcia 2015 Physical Therapy 6
George 2011 BMC Medicine 6
Grunnesjo 2011 Clinical Rehabilitation 7
Gunay 2014 Turkish Journal of Physiotherapy and Rehabilitation 7
Gupta 2012 Indian Journal of Physiotherapy and Occupational Therapy 2
Guthrie 2012 Journal of Sport Rehabilitation 6
Gutke 2010 Journal of Rehabilitation Medicine 6
Haakstad 2015 Journal of Rehabilitation Medicine 7
Haas 2014 The Spine Journal 5
Han 2011 Journal of Physical Therapy Science 4
Hartvigsen 2010 BMC Musculoskeletal Disorders 7
Hasegawa 2014 Acupuncture in Medicine 8
Hellum 2011 British Medical Journal 8
Henchoz 2010 Spine 6
Henchoz 2010 Swiss Medical Weekly 7
Henry 2014 The Spine Journal 6
Hidalgo 2015 Journal of Manipulative and Physiological Therapeutics 8
Hill 2015 Physical Therapy 6
Hoffman 2011 Manual Therapy 5
Homayouni 2015 Journal of Musculoskeletal Research 6
Hsieh 2014 Lasers in Medical Science 9
Huber 2011 Isokinetics and Exercise Science 6
Hugli 2015 Journal of Bodywork and Movement Therapies 7
Hurley 2015 Pain 6
Hwang 2013 Journal of Physical Therapy Science 4
Jacobson 2015 Evidence-Based Complementary and Alternative Medicine 7
Jain 2012 Indian Journal of Physiotherapy and Occupational Therapy 3
Jaromi 2012 Journal of Clinical Nursing 6
Javadian 2015 Caspian Journal of Internal Medicine 5
Javadian 2012 Journal of Back and Musculoskeletal Rehabilitation 4
Jensen 2012 BMC Musculoskeletal Disorders 5
Jensen 2015 Chiropractic & Manual Therapies 5
Jensen 2012 BMC Medicine 7
Johnsen 2014 Spine 5
Kamali 2012 Journal of Bodywork and Movement Therapies 6
Kawu 2011 Nigerian Journal of Clinical Practice 5
Kendall 2015 Journal of Science and Medicine in Sport 8
Khatri 2010 Indian Journal of Physiotherapy and Occupational Therapy 3
Kim 2015 International Journal of Osteopathic Medicine 8
Kluge 2011 International Journal of Gynaecology and Obstetrics 7
Kordi 2013 Journal of Back and Musculoskeletal Rehabilitation 5
Krammer 2015 New Zealand Journal of Physiotherapy 6
Kumar 2011 International Journal of Neurology and Neurosurgery 5
Lamb 2010 Health Technology Assessment 5
Lara-Palomo 2013 Clinical Rehabilitation 7
Lawand 2015 Joint, Bone, Spine 8
Learman 2013 Journal of Manipulative and Physiological Therapeutics 5
Lee 2015 Journal of Physical Therapy Science 5
Lee 2014 Journal of Physical Therapy Science 5
Lewis 2011 Journal of Physiotherapy 7
Licciardone 2013 The Journal of the American Osteopathic Association 7
Licciardone 2012 The Journal of the American Osteopathic Association 4
Licciardone 2013 Annals of Family Medicine 9
Lin 2015 PLoS ONE 6
Lomond 2014 Manual Therapy 5
Lu 2015 International Journal of Clinical and Experimental Medicine 5
(continued on next page)

www.archives-pmr.org
Abstracts of low back pain trials 10.e15

(continued )
First Author Year Journal Total PEDro Score 0/10
Lurie 2014 Spine 5
Macedo 2010 Fisioterapia em movimento 5
Macedo 2012 Physical Therapy 8
Machado 2010 BMC Medicine 8
Mannion 2013 The Spine Journal 5
Masse-Alarie 2013 The Clinical Journal of Pain 6
Mattila 2011 European Spine Journal 7
McGregor 2012 Spine 1
McMorland 2010 Journal of Manipulative and Physiological Therapeutics 6
Meng 2011 The Clinical Journal of Pain 6
Miyamoto 2013 Physical Therapy 8
Monro 2015 Journal of Back and Musculoskeletal Rehabilitation 6
Monticone 2015 European Journal of Pain 8
Moon 2013 Annals of Rehabilitation Medicine 8
Moon 2015 Journal of Physical Therapy Science 4
Moore 2012 The American Journal of the Medical Sciences 3
Morone 2011 European Journal of Physical and Rehabilitation Medicine 6
Morris 2011 Spine 3
Naik 2010 Indian Journal of Physiotherapy and Occupational Therapy 4
Naqaish 2013 Rawal Medical Journal 4
Nassif 2011 Archives of Physical Medicine and Rehabilitation 8
Natour 2015 Clinical Rehabilitation 8
Nazzal 2013 Neurosciences 7
Nemcic 2013 Acta Clinica Croatica 5
Oestergaard 2012 Spine 6
Ohtsuki 2012 Journal of Physical Therapy Science 2
Okafor 2012 South African Journal of Physiotherapy 2
Oke 2013 The West Indian Medical Journal 4
Olmedo-Buenrostro 2010 Revista de Investigacion Clinica 5
Omar 2012 International Journal of Rheumatic Diseases 5
Onac 2012 Journal of Cognitive and Behavioral Psychotherapies 6
Ozdemir 2015 Journal of Advanced Nursing 7
Ozkara 2015 Turkish Neurosurgery 6
Pach 2013 Evidence-Based Complementary and Alternative Medicine 5
Park 2014 Journal of Physical Therapy Science 4
Parreira 2014 Journal of Physiotherapy 9
Petersen 2011 Spine 7
Prommanon 2015 Journal of Physical Therapy Science 7
Pushpika 2010 An International Quarterly Journal of Research in Ayurveda 3
Ratajczak 2011 Journal of Back and Musculoskeletal Rehabilitation 4
Rhee 2012 Medical Science Monitor 5
Riva 2014 Journal of Medical Internet Research 6
Rogerson 2010 Pain Practice 4
Sakulsriprasert 2010 Indian Journal of Physiotherapy and Occupational Therapy 4
Saliba 2010 International Journal of Sports Physical Therapy 7
Saper 2013 Evidence-Based Complementary and Alternative Medicine 7
Selhorst 2015 The Journal of Manual & Manipulative Therapy 7
Senna 2011 Spine 8
Sharma 2011 Indian Journal of Physiotherapy and Occupational Therapy 5
Sheeran 2013 Spine 6
Sherman 2011 Archives of Internal Medicine 7
Shin 2013 Pain 8
Siemonsma 2013 Physical Therapy 7
Simmerman 2011 PM&R 4
Sokunbi 2014 South African Journal of Physiotherapy 5
Son 2014 Journal of Physical Therapy Science 3
Sorensen 2010 BMC Musculoskeletal Disorders 6
(continued on next page)

www.archives-pmr.org
10.e16 D.P. Nascimento et al

(continued )
First Author Year Journal Total PEDro Score 0/10
Suni 2013 Spine 5
Szlezak 2011 Manual Therapy 4
Szulc 2015 Medical Science Monitor 4
Tavafian 2011 The Clinical Journal of Pain 6
Tellez-Garcia 2015 Journal of Bodywork and Movement Therapies 7
Tilbrook 2011 Annals of Internal Medicine 5
Tilbrook 2014 Physiotherapy 4
Unsgaard-Tondel 2010 Physical Therapy 7
Vallone 2014 Photomedicine and Laser Surgery 5
Vasseljen 2010 Manual Therapy 6
Verma 2013 International Journal of Physiotherapy and Research 5
Vibe 2013 European Journal of Pain 6
Vidal 2013 European Spine Journal 5
Vieira-Pellenz 2014 Archives of Physical Medicine and Rehabilitation 8
Vincent 2014 PM&R 6
Vong 2011 Archives of Physical Medicine and Rehabilitation 6
Wajswelner 2012 Medicine and Science in Sports and Exercise 7
Wand 2013 British Journal of Sports Medicine 5
Wand 2012 The Clinical Journal of Pain 6
Weis 2013 Journal of Alternative & Complementary Medicine 9
Xia 2011 Journal of Acupuncture and Tuina Science 3
Yardley 2010 Family Practice 3
Yeh 2010 Acta Anaesthesiologica Taiwanica 2
Yeh 2011 International Journal of Nursing Studies 8
Yildirim 2010 Journal of Back and Musculoskeletal Rehabilitation 4
Yoo 2014 International Journal of Clinical Practice 4
Yoon 2012 Annals of Rehabilitation Medicine 5
You 2014 Clinical Rehabilitation 6
You 2015 Journal of Physical Therapy Science 4
Yuan 2013 Evidence-Based Complementary and Alternative Medicine 7
Yun 2012 Journal of Alternative & Complementary Medicine 6
Zahari 2014 International Journal of Pharma and Bio Sciences 3
Zaringhalam 2010 Chinese Medicine 6
Zhang 2014 The Journal of International Medical Research 6
Zheng 2012 Journal of Traditional Chinese Medicine 6

www.archives-pmr.org
Abstracts of low back pain trials 10.e17

Supplemental Appendix S5
Agreement of data extraction between the two authors who
collected the data. Kappa coefficient is presented for each item of
the CONSORT-A and the SPIN-checklist for both abstract and full
text (nZ200).

Item Description Kappa Coefficient

CONSORT-A applied to the abstracts 1. Title 0.96
2. Trial design 0.94
3. Participants 0.76
4. Interventions 0.47
5. Objective 0.52
6. Outcome 0.84
7. Randomization 0.75
8. Blinding 0.66
9. Numbers randomized 0.87
10. Numbers analyzed 0.72
11. Outcome results 0.35
12. Harms 0.81
13. Conclusions 0.53
14. Trial registration 0.94
15. Funding 0.87
CONSORT-A applied to the full-text 1. Title 0.96
2. Trial design 0.91
3. Participants 0.69
4. Interventions 0.57
5. Objective 0.65
6. Outcome 0.90
7. Randomization 0.70
8. Blinding 0.54
9. Numbers randomized 0.58
10. Numbers analyzed 0.84
11. Outcome results 0.60
12. Harms 0.77
13. Conclusions 0.40
14. Trial registration 0.92
15. Funding 0.87
Range from fair to almost perfect agreement Mean 0.73 (SD 0.18)
SPIN-checklist applied to the abstracts 1. Omission of primary outcome 0.82
2. Fail to mention adverse events 0.80
3. Selective reporting of outcomes 0.53
4. Fail to report statistically non-significant outcomes 0.57
5. Focus on statistically significant outcomes 0.68
6. Over-enthusiastic interpretation of outcomes 0.66
7. Recommendation of a treatment 0.49
SPIN-checklist applied to the full-text 1. Omission of primary outcome 0.81
2. Fail to mention adverse events 0.79
3. Selective reporting of outcomes 0.65
4. Fail to report statistically non-significant outcomes 0.71
5. Focus on statistically significant outcomes 0.63
6. Over-enthusiastic interpretation of outcomes 0.71
7. Recommendation of a treatment 0.53
Range from moderate to almost perfect agreement Mean 0.67 SD (0.11)

www.archives-pmr.org
10.e18 D.P. Nascimento et al

Supplemental Appendix S6
Agreement between abstract and full text for the classifications of
each item of the CONSORT-A and the SPIN-checklist (nZ200).
Calculated with Kappa coefficient.

Item Description Kappa Coefficient

CONSORT-A classified as “fully reported” and “not 1. Title *Not applicable
reported”. The checklist was applied to the 2. Trial design 0.33
abstract and to the full text. 3. Participants 0.12
4. Interventions 0.16
5. Objective 0.10
6. Outcome 0.45
7. Randomization 0.03
8. Blinding 0.19
9. Numbers randomized 0.10
10. Numbers analyzed 0.03
11. Outcome results 0.18
12. Harms 0.21
13. Conclusions 0.51
14. Trial registration 0.18
15. Funding 0.25
Range from slight to moderate agreement Mean 0.20 (SD 0.14)
SPIN-checklist classified as “yes” and “no”. The 1. Omission of primary outcome 0.50
checklist was applied to the abstract and to 2. Fail to mention adverse events 0.26
the full text. 3. Selective reporting of outcomes 0.49
4. Fail to report statistically non-significant outcomes 0.48
5. Focus on statistically significant outcomes 0.57
6. Over-enthusiastic interpretation of outcomes 0.53
7. Recommendation of a treatment 0.57
Range from fair to moderate agreement Mean 0.49 (SD 0.11)
* Note: The first item is ‘Not applicable’ because it is related to the title. Standard Deviation (SD).

www.archives-pmr.org